Cesarean scar pregnancy: noninvasive and effective treatment with high-intensity focused ultrasound.
OBJECTIVE
The aim of this preliminary study was to investigate whether ultrasound-guided high-intensity focused ultrasound (HIFU) can play a role in treating cesarean scar pregnancy (CSP).


METHODS
Between November 2011 and December 2012, 16 patients with CSP were treated with ultrasound-guided HIFU ablation. Successful treatment was defined as disappearance of CSP mass, undetectable serum beta human chorionic gonadotropin, and no serious complications such as severe bleeding, uterine rupture, or hysterectomy.


RESULTS
All patients were successfully treated in the outpatient department and none required readmission. After 2-5 treatment sessions, the mean time for achieving undetectable serum beta human chorionic gonadotropin was 4.94 ± 2.32 weeks, and the mean time for CSP mass disappearance was 6.69 ± 3.36 weeks. Three patients experienced moderate abdominal pain that subsided in 1-2 days, and nine patients experienced mild vaginal bleeding (<30 mL) that resolved within 2-3 days. All 16 patients had recovered their normal menstruation function at follow-up.


CONCLUSIONS
These preliminary results suggest that ultrasound-guided HIFU ablation is a noninvasive, feasible, and effective method for the treatment of CSP.
Department of Ultrasound, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi Province, People's Republic of China.
Juhua
J
Xiao
Department of General Surgery, Jiangxi Children's Hospital, Nanchang, Jiangxi Province, People's Republic of China.
Shouhua
S
Zhang
Department of Ultrasound, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.
Fang
F
Wang
Department of Ultrasound, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi Province, People's Republic of China.
Yuqin
Y
Wang
Department of Ultrasound, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.
Zhen
Z
Shi
Department of Ultrasound, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi Province, People's Republic of China.
Xin
X
Zhou
Department of Ultrasound, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.
Jinshui
J
Zhou
Department of General Surgery, Jiangxi Children's Hospital, Nanchang, Jiangxi Province, People's Republic of China.
Jinshi
J
Huang
D000328:Adult; D002585:Cesarean Section; D002921:Cicatrix / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D057086:High-Intensity Focused Ultrasound Ablation; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional
cesarean scar pregnancy; high intensity focused ultrasound; noninvasive treatment