Surgical treatment of Cesarean scar ectopic pregnancy: efficacy and safety of ultrasound‐guided suction curettage

• DOI: 10.1002/uog.15857
• Publication Date: 2016-01-14T14:44:06Z
• Authors: D. Jurkovic; J. Knez; A. Appiah; L. Farahani; D. Mavrelos; J. A. Ross
• Keywords: Dilation and curettage; Curettage; Vascularity

ABSTRACT Objectives To assess the efficacy of ultrasound‐guided suction curettage for management pregnancies implanted into lower uterine segment Cesarean section scar. Methods This was a retrospective study including women diagnosed with scar pregnancy at two large tertiary referral early units between 1997 and 2014. Surgical evacuation offered to selected presenting in first trimester ≤ 14 weeks' gestation. All procedures were performed transcervically under ultrasound guidance using curettage. A modified Shirodkar cervical suture used who required additional measures secure hemostasis. Results total 232 seen units; 191/232 (82.3%) treated surgically. The median intraoperative blood loss 100 mL (range, 10–3000 ); 9/191 (4.7% (95% CI , 1.7–7.7%)) transfusion and, one (0.5% 0–1.5%)), life‐saving hysterectomy had be because uncontrollable bleeding. Of attended follow‐up, 7/116 (6.0% 1.7–10.3%)) repeat surgical procedure retained products conception. Multivariable analysis showed that gestational sac diameter (odds ratio ( OR ), 1.10 1.03–1.17)) vascularity on Doppler examination 3.41 1.39–8.33)) significant predictors heavy (> 1000 ). Conclusions Ultrasound‐guided is an effective method treatment associated low risk hysterectomy. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.