Transvaginal ultrasound-guided local methotrexate administration as the first-line treatment for cesarean scar pregnancy: Follow-up of 18 cases
JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH, vol.41, no.5, pp.803-808, 2015 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 41 Issue: 5
- Publication Date: 2015
- Doi Number: 10.1111/jog.12627
- Journal Name: JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Page Numbers: pp.803-808
- Keywords: cesarean scar pregnancy, ectopic pregnancy, local, methotrexate, ultrasound-guided, SECTION SCAR, ARTERIOVENOUS-MALFORMATION, ECTOPIC PREGNANCIES, MANAGEMENT OPTIONS, ASPIRATION, DIAGNOSIS
- Inonu University Affiliated: No
Abstract
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.