Is ultrasound-guided suction curettage a reliable option for treatment of cesarean scar pregnancy? A cross-sectional retrospective study

• Published in: The journal of maternal-fetal & neonatal medicine Vol. 31; no. 22; p. 2953
• Main Authors: Özcan, Hüseyin Çağlayan, Uğur, Mete Gurol, Balat, Özcan, Sucu, Seyhun, Mustafa, Aynur, Bayramoğlu Tepe, Neslihan, Uğur, Berna Kaya
• Format: Journal Article
• Language: English
• Published: England 17.11.2018
• Subjects: Adult; Cesarean Section - adverse effects; Cicatrix - complications; Cross-Sectional Studies; Female; Humans; Pregnancy; Pregnancy, Ectopic - etiology; Pregnancy, Ectopic - surgery; Retrospective Studies; Ultrasonography, Interventional; Vacuum Curettage; Abdominal hysterectomy; ultrasound-guided dilation and curettage; cesarean scar pregnancy
• ISSN: 1476-4954
• DOI: 10.1080/14767058.2017.1359827

The purpose of our study is to present clinical courses and outcomes of 50 first-trimester cesarean scar pregnancy (CSP) cases, which are managed either with transabdominal ultrasound (TAUS)-guided suction curettage alone or abdominal hysterotomy. We retrospectively analyzed our records from 2011 to 2016 at a single-center. TAUS-guided suction curettage alone was preferred in hemodynamically stable patients when the myometrial thickness was ≥3 mm and there was no vascular invasion. If the myometrial thickness was <3 mm and/or vascular invasion was present, then hysterotomy was preferred. Statistical analysis of age, gravidity, parity, history of previous CS (≥3 or <3), presence of embryonic cardiac activity, complaints (vaginal bleeding, pelvic pain, or both), preoperative and postoperative hemoglobin levels (g/dl), blood transfusion, initial serum β-hCG levels, and duration to resolution of β-hCG demonstrated no significant difference between TAUS-guided suction curettage and abdominal hysterotomy groups. There was a significant difference between two groups in terms of postoperative length of stay in the hospital and gestational age. TAUS-guided suction curettage in selected cases may be considered as a reliable first-line treatment option due to its low cost, ease of application, lower side-effect profile, and potentially minimal influence on future fertility in CSP patients that are hemodynamically stable.