Clinical characteristics and treatment of different types of cesarean scar pregnancy
Abstract
Objectives: The purpose of this study was to evaluate the clinical characteristics and compare the treatment efficacy of
different types of cesarean scar pregnancy (CSP).
Material and methods: We performed a retrospective chart review of 66 women (69 cases) with CSP who received treatment
with mifepristone/methotrexate (MTX) plus curettage, uterine artery embolization (UAE) plus curettage, additional
MTX, or laparotomy, and compared the clinical characteristics, treatment efficacy, and occurrence of complications among
3 types of CSP (partial, complete, and mass type).
Results: Review of the 69 cases revealed a considerable increase of gestational duration(p < 0.001), sac/lesion size(p < 0.001)
and vaginal bleeding (p < 0.05) in patients with mass-type CSP compared to that of other types. All CSP cases were successfully
treated, 4 cases of mass-type received laparotomy and none of the cases required a hysterectomy. Severe bleeding
was observed in 2 cases of partial-type and complete-type, respectively, and 3 cases for mass-type. Moreover, bleeding
occurred during initial treatment with mifepristone plus curettage in partial-type cases, but not with UAE plus curettage.
Conclusions: UAE plus curettage is a more effective treatment option for partial- and complete-type of CSP than mifepristone
plus curettage. The cases of mass-type often need surgery and are prone to have longer gestational duration, larger
lesions, and more vaginal bleeding.
Keywords: cesarean scar pregnancyclinical characteristicstreatment efficacycomplication
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