Conservative management of ectopic pregnancy – observations and bhCG titres

Objectives: The aim of this study was to investigate the efficacy and safety of uterine artery embolization (UAE) combined with intra-arterial methotrexate (MTX) infusion for the treatment of caesarean scar pregnancy (CSP), compared with systemic MTX injection combined with uterine curettage. Study design: A retrospective cohort study. An analysis of CSP patients was performed using records from the Department of Obstetrics and Gynecology in Renji Hospital for the period between January 1, 2000 and December 30, 2010. Twenty-two patients received UAE combined with intra-arterial MTX infusion and in this group 16 patients received uterine curettage after UAE, whereas 25 patients received intramuscular MTX injection and subsequent uterine curettage. The clinical information on these patients and clinical outcomes were reviewed. Results: All patients in the UAE group were treated successfully and 2 patients in the non-UAE group had to undergo hysterectomy or uterine repair. No patients in the UAE group had recurrent vaginal bleeding of more than 100 ml/day after treatment, while 8 patients in the non-UAE group did, and this difference was significant. The blood loss during uterine curettage in the UAE group was much less than in non-UAE group. The serum beta-hCG level in the UAE group recovered more quickly than in the non-UAE group, and hospital stay was significantly shorter in the UAE group. Conclusions: UAE combined with intraarterial MTX infusion turned out to be an effective and safe treatment for CSP. 2011 Elsevier Ireland Ltd. Source: EMBASE Full Text: Available in fulltext at ULHT journal article requests. Complete the online form to obtain articles. 2. Transvaginal ultrasound-guided embryo aspiration plus local administration of low-dose methotrexate for caesarean scar pregnancy Author(s): Li N., Zhu F., Fu S., Shi X. Citation: Ultrasound in Medicine and Biology, February 2012, vol./is. 38/2(209-213), 03015629;1879-291X (February 2012)