Transvaginal ultrasound-guided local methotrexate administration as the first-line treatment for cesarean scar pregnancy: Follow-up of 18 cases

Cok T., Kalayci H., Ozdemir H., Haydardedeoglu B., Parlakgumus A. H., Tarim E.

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH, cilt.41, sa.5, ss.803-808, 2015 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 41 Sayı: 5
  • Basım Tarihi: 2015
  • Doi Numarası: 10.1111/jog.12627
  • Dergi Adı: JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.803-808
  • Anahtar Kelimeler: cesarean scar pregnancy, ectopic pregnancy, local, methotrexate, ultrasound-guided, SECTION SCAR, ARTERIOVENOUS-MALFORMATION, ECTOPIC PREGNANCIES, MANAGEMENT OPTIONS, ASPIRATION, DIAGNOSIS
  • İnönü Üniversitesi Adresli: Hayır

Özet

Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy, which occurs in previous cesarean section scar tissue, with an incidence of 1 in 1800-3000 pregnancies. Transvaginal ultrasound-guided local methotrexate (MTX) administration presents as a non-systemic option with possible better penetration to the pregnancy site. We present the management of 18 patients with CSP solely by transvaginal ultrasound-guided local MTX administration. All patients were treated with local MTX with a dose of 50mg/m(2). Eleven (61.1%) of the patients did not need any further intervention. Four patients (22.2%) were treated with additional single-dose systemic MTX due to inadequate alteration in blood -human chorionic gonadotrophin levels. Three patients (16.7%) required hysteroscopy and/or laparotomy. We suggest that transvaginal ultrasound-guided local MTX treatment may be considered as a first-line treatment for CSP.