title: Assessment of transvaginal hysterotomy combined with medication for cesarean scar ectopic pregnancy.
abstract: The objective of this retrospective study was to explore a novel surgical technique, transvaginal hysterotomy combined with methotrexate injection, for treatment of cesarean scar ectopic pregnancy in 12 patients. All patients underwent the operation. Mean (SD; 95% CI) operative time was 21.6 (7.3; 17.0-26.2) minutes, and intraoperative blood loss was 90.8 (59.6; 52.9-128.7) mL. Postoperative ultrasonography confirmed removal of the pregnancy sac. The length of hospital stay was 7.4 (3.7; 5.0-9.8) days. The first normal postoperative menstrual period was at 28.3 (5.6; 24.7-31.9) days after surgery. The serum β-human chorionic gonadotropin concentration returned to normal at 15.8 (6.3; 11.8-19.8) days. We conclude that surgical removal of the ectopic sac via transvaginal hysterotomy combined with methotrexate injection during the operation is a potentially good new approach to treatment of cesarean scar ectopic pregnancy. The efficacy and safety of the technique need further confirmation in future studies.
authors.affiliation: Department of Obstetrics and Gynecology, Affiliated Shenzhen Nanshan People's Hospital of Guangdong Medical University, Shenzhen, China.
authors.forename: Zhonghai
authors.initials: Z
authors.lastname: Wang
authors.forename: Aiwen
authors.initials: A
authors.lastname: Le
authors.forename: Lili
authors.initials: L
authors.lastname: Shan
authors.forename: Tianhui
authors.initials: T
authors.lastname: Xiao
authors.forename: Rong
authors.initials: R
authors.lastname: Zhuo
authors.forename: Huijuan
authors.initials: H
authors.lastname: Xiong
authors.forename: Yi
authors.initials: Y
authors.lastname: Shen
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000328:Adult; D002585:Cesarean Section; D002921:Cicatrix / Q000150:complications*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D020883:Hysterotomy / Q000379:methods*; D008727:Methotrexate / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014621:Vagina
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate