title: Transcatheter arterial chemoembolization versus systemic methotrexate for the management of cesarean scar pregnancy.
abstract: OBJECTIVE
  To evaluate the effectiveness/safety of systemic methotrexate (MTX) treatment versus transcatheter arterial chemoembolization using different embolic agents for termination of cesarean scar pregnancy (CSP).
  
  
  METHODS
  Women with CSP were randomized to receive intravenous infusion of MTX (group 1, n=13), or chemoembolization with MTX and either gelatin sponge (GS; group 2, n=15) or polyvinyl alcohol (PVA; group 3, n=16) particles. Uterine suction curettage followed all procedures. Bleeding volume, time until resolution of serum β-hCG, and length of hospital stay were recorded as outcome endpoints.
  
  
  RESULTS
  Bleeding volume was smaller in groups 2 (mean ± SD, 73±20 mL) and 3 (63±22 mL) than in group 1 (952±471 mL) (P<0.001). Time until resolution of β-hCG was shorter in groups 2 (29±16 days) and 3 (30±19 days) than in group 1 (57±25 days) (P<0.01). Length of hospital stay was shorter in groups 2 (13±4 days) and 3 (12±3 days) than in group 1 (36±8 days) (P<0.01).
  
  
  CONCLUSIONS
  Transcatheter arterial chemoembolization was more effective than systemic MTX treatment for termination of CSP. Large cohort studies are warranted to compare effectiveness between PVA and GS particles.
authors: Department of Radiology, Qilu Hospital, Shandong University, Jinan, China.
authors: Chunhai
authors: C
authors: Li
authors: Caixia
authors: C
authors: Li
authors: Danjun
authors: D
authors: Feng
authors: Chunling
authors: C
authors: Jia
authors: Bin
authors: B
authors: Liu
authors: Xinfeng
authors: X
authors: Zhan
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000328:Adult; D002585:Cesarean Section; D002921:Cicatrix; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D005781:Gelatin Sponge, Absorbable; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage*; D011142:Polyvinyl Alcohol / Q000008:administration & dosage; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D055357:Uterine Artery Embolization
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D011142:Polyvinyl Alcohol; D008727:Methotrexate