Methotrexate uterine artery chemoembolization combined with curettage for treating cesarean scar pregnancies
10.13929/j.issn.1672-8475.2024.10.005
- VernacularTitle:氨甲蝶呤子宫动脉化疗栓塞联合清宫术治疗瘢痕妊娠
- Author:
Lingyan XIA
1
;
Anle WU
Author Information
1. 宁波市海曙区人民医院放射科,浙江 宁波 315000
- Keywords:
pregnancy,ectopic;
chemoembolization,therapeutic;
cesarean scar pregnancy
- From:
Chinese Journal of Interventional Imaging and Therapy
2024;21(10):592-595
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy and safety of methotrexate(MTX)uterine artery chemoembolization(UACE)combined with curettage for treating cesarean scar pregnancies(CSP).Methods A total of 29 CSP patients diagnosed by ultrasound and/or MRI and underwent UACE and curettage within 72 h after UACE were retrospectively collected.The therapeutic efficacy was evaluated,the amount of blood loss and gestational matter were recorded.The treatment-related complications were observed,blood β-human chorionic gonadotropin(β-HCG)and changes on ultrasonic images were explored after treatment,and the menstrual status was followed up.Results UACE and sequential curettage were successfully performed in all 29 cases.The amount of blood loss during curettage was 5-50 ml with a median of 10 m,l and the gestational matter was 10-100 ml with a median of 20 ml.Vagal reflex occurred in 1 case during UACE but improved after intravenous injection of 1 mg atropine.One week after UACE,post-embolization syndrome occurred in all 29 cases,which resolved after treatment with methylprednisolone.After combination treatment,blood β-HCG decreased from 78 997.00(23 150.50,201 975.50)mIU/ml before treatment to 2 873.00(1 873.00,4 182.50)mIU/ml(Z=-6.322,P=0.001).Blood β-HCG returned to normal 15-27 days after combination treatment,with a mean time of(20.2±3.3)days.One month after combination treatment,ultrasound showed clear endometrial line without residual recurrence of lesions.Menstruation cycle restored in all 29 cases 1.0-1.5 months after combination treatment.Conclusion MTX UACE combined with curettage was effective and safe for treating CSP.
