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Published in: Archives of Gynecology and Obstetrics 6/2014

01-06-2014 | Review

Management of cesarean scar pregnancy with suction curettage: a report of four cases and review of the literature

Authors: Yeşim Bayoglu Tekin, Ulku Mete Ural, Gulşah Balık, Isık Ustuner, Figen Kır Şahin, Emine Seda Güvendağ Güven

Published in: Archives of Gynecology and Obstetrics | Issue 6/2014

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Abstract

Purpose

To present the outcomes of four cases of cesarean scar pregnancy treated with suction curettage.

Methods

Four patients were ultrasonographically diagnosed with cesarean scar pregnancies treated with suction curettage in a tertiary care center.

Results

Serum β-human chorionic gonadotropin levels ranged between 1,681 and 15,573 mU/mL, gestational sac diameter measured from 10 to 24 mm and scar thickness was between 4.7 and 6.8 mm. All patients underwent suction curettage under general anesthesia with transabdominal ultrasonography guidance. No complications were observed during or after operation.

Conclusion

Suction curettage is a viable alternative for conservative treatment in selected cases of patients who are diagnosed with CSP early in gestation and who have a myometrial thickness of more than 4.5 mm.
Literature
1.
go back to reference Rotas MA, Haberman S, Levgur M (2006) Cesarean scar ectopic pregnancies: etiology, diagnosis, and management. Obstet Gynecol 107:1373–1381PubMedCrossRef Rotas MA, Haberman S, Levgur M (2006) Cesarean scar ectopic pregnancies: etiology, diagnosis, and management. Obstet Gynecol 107:1373–1381PubMedCrossRef
2.
go back to reference Jurkovic D, Hillaby K, Woelfer B, Lawrence A, Salim R, Elson CJ (2003) First-trimester diagnosis and management of pregnancies implanted into the lower uterine segment cesarean section scar. Ultrasound Obstet Gynecol 21:220–227PubMedCrossRef Jurkovic D, Hillaby K, Woelfer B, Lawrence A, Salim R, Elson CJ (2003) First-trimester diagnosis and management of pregnancies implanted into the lower uterine segment cesarean section scar. Ultrasound Obstet Gynecol 21:220–227PubMedCrossRef
3.
go back to reference Fylstra DL (2002) Ectopic pregnancy within a cesarean scar: a review. Obstet Gynecol Surv 57:537–543PubMedCrossRef Fylstra DL (2002) Ectopic pregnancy within a cesarean scar: a review. Obstet Gynecol Surv 57:537–543PubMedCrossRef
4.
go back to reference Larsen JV, Solomon MH (1978) Pregnancy in a uterine scar sacculus-an unusual cause of postabortal haemorrhage. A case report. S Afr Med J 28:123–142 Larsen JV, Solomon MH (1978) Pregnancy in a uterine scar sacculus-an unusual cause of postabortal haemorrhage. A case report. S Afr Med J 28:123–142
5.
go back to reference Timor-Tritsch IE, Monteagudo A, Santos R, Tsymbal T, Pineda G, Arslan AA (2012) The diagnosis, treatment, and follow-up of cesarean scar pregnancy. Am J Obstet Gynecol 207:44.e1–44.e13CrossRef Timor-Tritsch IE, Monteagudo A, Santos R, Tsymbal T, Pineda G, Arslan AA (2012) The diagnosis, treatment, and follow-up of cesarean scar pregnancy. Am J Obstet Gynecol 207:44.e1–44.e13CrossRef
6.
go back to reference Arslan M, Pata O, Dilek TU, Aktas A, Aban M, Dilek S (2005) Treatment of viable cesarean scar ectopic pregnancy with suction curettage. Int J Gynaecol Obstet 89:163–166PubMedCrossRef Arslan M, Pata O, Dilek TU, Aktas A, Aban M, Dilek S (2005) Treatment of viable cesarean scar ectopic pregnancy with suction curettage. Int J Gynaecol Obstet 89:163–166PubMedCrossRef
7.
go back to reference Nonaka M, Toyoki H, Imai A (2006) Cesarean section scar pregnancy may be the cause of serious hemorrhage after first-trimester abortion by dilatation and curettage. Int J Gynaecol Obstet 95:50–51PubMedCrossRef Nonaka M, Toyoki H, Imai A (2006) Cesarean section scar pregnancy may be the cause of serious hemorrhage after first-trimester abortion by dilatation and curettage. Int J Gynaecol Obstet 95:50–51PubMedCrossRef
8.
go back to reference Seow KM, Huang LW, Lin YH, Lin MY, Tsai YL, Hwang JL (2004) Cesarean scar pregnancy: issues in management. Ultrasound Obstet Gynaecol 23:247–253CrossRef Seow KM, Huang LW, Lin YH, Lin MY, Tsai YL, Hwang JL (2004) Cesarean scar pregnancy: issues in management. Ultrasound Obstet Gynaecol 23:247–253CrossRef
9.
go back to reference Polat I, Alkis I, Sahbaz A, Sahin O, Ekiz A, Gulac B, Tekirdag AI (2012) Diagnosis and management of cesarean scar pregnancy. Clin Exp Obstet Gynecol 39:365–368PubMed Polat I, Alkis I, Sahbaz A, Sahin O, Ekiz A, Gulac B, Tekirdag AI (2012) Diagnosis and management of cesarean scar pregnancy. Clin Exp Obstet Gynecol 39:365–368PubMed
10.
go back to reference Wang CB, Tseng CJ (2006) Primary evacuation therapy for cesarean scar pregnancy: three new cases and review. Ultrasound Obstet Gynecol 27:222–226PubMedCrossRef Wang CB, Tseng CJ (2006) Primary evacuation therapy for cesarean scar pregnancy: three new cases and review. Ultrasound Obstet Gynecol 27:222–226PubMedCrossRef
12.
go back to reference Jiang T, Liu G, Huang L, Ma H, Zhang S (2011) Methotrexate therapy followed by suction curettage followed by Foley tamponade for caesarean scar pregnancy. Eur J Obstet Gynecol Reprod Biol 156:209–211PubMedCrossRef Jiang T, Liu G, Huang L, Ma H, Zhang S (2011) Methotrexate therapy followed by suction curettage followed by Foley tamponade for caesarean scar pregnancy. Eur J Obstet Gynecol Reprod Biol 156:209–211PubMedCrossRef
13.
go back to reference Fahg A, Chen Q, Qian Z, Li Q, Meng Y (2009) Correlation questions clinical discussion of uterine artery embolization in induced abortion patients with management of cesarean scar pregnancy. J Reprod Contra 20:153–160CrossRef Fahg A, Chen Q, Qian Z, Li Q, Meng Y (2009) Correlation questions clinical discussion of uterine artery embolization in induced abortion patients with management of cesarean scar pregnancy. J Reprod Contra 20:153–160CrossRef
14.
go back to reference Yin X, Su S, Dong B, Ban Y, Li C, Sun B (2012) Angiographic uterine artery chemoembolization followed by vacuum aspiration: an efficient and safe treatment for managing complicated cesarean scar pregnancy. Arch Gynecol Obstet 285:1313–1318PubMedCrossRef Yin X, Su S, Dong B, Ban Y, Li C, Sun B (2012) Angiographic uterine artery chemoembolization followed by vacuum aspiration: an efficient and safe treatment for managing complicated cesarean scar pregnancy. Arch Gynecol Obstet 285:1313–1318PubMedCrossRef
15.
go back to reference Yang XY, Yu H, Li KM, Chu YX, Zheng A (2010) Uterine artery embolisation combined with local methotrexate for treatment of caesarean scar pregnancy. BJOG 117:990–996PubMedCrossRef Yang XY, Yu H, Li KM, Chu YX, Zheng A (2010) Uterine artery embolisation combined with local methotrexate for treatment of caesarean scar pregnancy. BJOG 117:990–996PubMedCrossRef
16.
go back to reference Zhang Y, Gu Y, Wang JM, Yi L (2013) Analysis of cases with cesarean scar pregnancy. J Obstet Gynaecol Res. 39:195–202PubMedCrossRef Zhang Y, Gu Y, Wang JM, Yi L (2013) Analysis of cases with cesarean scar pregnancy. J Obstet Gynaecol Res. 39:195–202PubMedCrossRef
17.
go back to reference Lan W, Hu D, Li Z, Wang L, Yang W, Hu S (2013) Bilateral uterine artery chemoembolization combined with dilation and curettage for treatment of cesarean scar pregnancy: a method for preserving the uterus. J Obstet Gynaecol Res. 39:1153–1158PubMedCrossRef Lan W, Hu D, Li Z, Wang L, Yang W, Hu S (2013) Bilateral uterine artery chemoembolization combined with dilation and curettage for treatment of cesarean scar pregnancy: a method for preserving the uterus. J Obstet Gynaecol Res. 39:1153–1158PubMedCrossRef
18.
go back to reference Ghezzi F, Laganà D, Franchi M, Fugazzola C, Bolis P (2002) Conservative treatment by chemotherapy and uterine arteries embolization of a cesarean scar pregnancy. Eur J Obstet Gynecol Reprod Biol 103:88–91PubMedCrossRef Ghezzi F, Laganà D, Franchi M, Fugazzola C, Bolis P (2002) Conservative treatment by chemotherapy and uterine arteries embolization of a cesarean scar pregnancy. Eur J Obstet Gynecol Reprod Biol 103:88–91PubMedCrossRef
Metadata
Title
Management of cesarean scar pregnancy with suction curettage: a report of four cases and review of the literature
Authors
Yeşim Bayoglu Tekin
Ulku Mete Ural
Gulşah Balık
Isık Ustuner
Figen Kır Şahin
Emine Seda Güvendağ Güven
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 6/2014
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-014-3143-6

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