Methotrexate therapy for cesarean section scar pregnancy with and without suction curettage.
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.
Wang
Jian-Hua
JH
Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
Xu
Kai-Hong
KH
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.
Lin
Jun
J
Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
Xu
Jian-Yun
JY
Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
Wu
Rui-Jin
RJ
Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
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
D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate