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Methotrexate therapy for cesarean section scar pregnancy with and without suction curettage
Jian-Hua Wang1, Kai-Hong Xu1, Jun Lin1
1Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
Objective:
To compare the clinical effects in women with cesarean scar pregnancy (CSP) who were treated with either methotrexate (MTX) regimen only or MTX regimen followed by dilation and curettage (D&C).
Design:
Prospective consecutive clinical cohort study.
Setting:
University hospital for obstetrics, gynecology, and reproductive medicine.
Subject(S):
Seventy-one cases of CSP.
Intervention(S):
The subjects were treated with either MTX only (MTX group, 21 cases) or MTX followed by D&C (combined therapy group, 50 cases).
Main Outcome Measure(S):
Success rates, hysterectomy rates, and time to resolution of serum beta-hCG and the CSP mass were compared between the two groups.
Result(S):
Compared with the MTX group, the combined therapy group had a shorter time to resolution of the CSP mass and serum beta-hCG. There was no significant difference between the MTX and combined therapy groups regarding success rates (76.2% vs. 90.0%, respectively) and hysterectomy rates (19.0% vs. 8.0%, respectively).
Conclusion(S):
Both therapies could treat the majority of CSP patients successfully, but the combined therapy resulted in a shorter time of therapy and indicated a more favorable effect.
