title: Methotrexate therapy for cesarean section scar pregnancy with and without suction curettage.
abstract: 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).
  
  
  METHODS
  Prospective consecutive clinical cohort study.
  
  
  METHODS
  University hospital for obstetrics, gynecology, and reproductive medicine.
  
  
  METHODS
  Seventy-one cases of CSP.
  
  
  METHODS
  The subjects were treated with either MTX only (MTX group, 21 cases) or MTX followed by D&C (combined therapy group, 50 cases).
  
  
  METHODS
  Success rates, hysterectomy rates, and time to resolution of serum beta-hCG and the CSP mass were compared between the two groups.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China. Electronic address: xukhhz@163.com.
authors.forename: Kai-Hong
authors.initials: KH
authors.lastname: Xu
authors.affiliation: Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
authors.forename: Jian-Yun
authors.initials: JY
authors.lastname: Xu
authors.affiliation: Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
authors.forename: Rui-Jin
authors.initials: RJ
authors.lastname: Wu
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000150:complications* / Q000209:etiology; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy* / Q000209:etiology*; D016896:Treatment Outcome; D014619:Vacuum Curettage / Q000379:methods; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate