title: Suction curettage as first line treatment in cases with cesarean scar pregnancy: feasibility and effectiveness in early pregnancy.
abstract: OBJECTIVE
  A cesarean scar pregnancy (CSP) is an extremely rare form of an ectopic pregnancy, which is defined as the localization of a fertilized ovum surrounded by uterine muscular fiber and scar tissue. The objective of this study was to discuss the management options for CSPs in a singleton center. In the current study, we discussed the current management options for CSPs based on our 6 years of experience.
  
  
  METHODS
  A retrospective evaluation of diagnosed and treated 26 patients with CSPs in Istanbul Kanuni Sultan Suleyman Training and Research Hospital during a 6-year period was discussed. Suction curettage was performed as first-line treatment in patients with a gestation <8 weeks and myometrial thickness >2 mm.
  
  
  RESULTS
  Twenty-two (84.6%) patients with CSPs were initially treated surgically (curettage and hysterotomy) and four (15.4%) patients were treated medically with methotrexate injections. Vacuum aspiration was performed in 19 patients as a first-line treatment, six of them needed an additional Foley balloon catheter to be inserted for tamponade because of persistent vaginal bleeding. Suction curettage was successful in 12 patients. The treatment rate for suction curettage with or without Foley balloon catheter tamponade was 16 of 19 (84.2%).
  
  
  CONCLUSIONS
  The early diagnosis of a CSP (7-8 weeks gestation) with a β-hCG level <17.000 mIU/ml and a myometrial thickness >2 mm can be treated with suction curettage with or without placement of a uterine Foley balloon as curative treatment.
authors.affiliation: a Department of Obstetrics and Gynecology , Maternal-Fetal Medicine Unit, Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey and.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Polat
authors.affiliation: a Department of Obstetrics and Gynecology , Maternal-Fetal Medicine Unit, Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey and.
authors.forename: Ali
authors.initials: A
authors.lastname: Ekiz
authors.affiliation: a Department of Obstetrics and Gynecology , Maternal-Fetal Medicine Unit, Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey and.
authors.forename: Deniz Kanber
authors.initials: DK
authors.lastname: Acar
authors.affiliation: a Department of Obstetrics and Gynecology , Maternal-Fetal Medicine Unit, Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey and.
authors.forename: Basak
authors.initials: B
authors.lastname: Kaya
authors.affiliation: a Department of Obstetrics and Gynecology , Maternal-Fetal Medicine Unit, Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey and.
authors.forename: Burak
authors.initials: B
authors.lastname: Ozkose
authors.affiliation: a Department of Obstetrics and Gynecology , Maternal-Fetal Medicine Unit, Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey and.
authors.forename: Cagdas
authors.initials: C
authors.lastname: Ozdemir
authors.affiliation: b Department of Obstetrics and Gynecology , Mardin Maternity and Children Disease Hospital , Mardin , Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Talay
authors.affiliation: a Department of Obstetrics and Gynecology , Maternal-Fetal Medicine Unit, Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey and.
authors.forename: Ali
authors.initials: A
authors.lastname: Gedikbasi
mesh_terms: D000025:Abortion, Eugenic / Q000009:adverse effects / Q000379:methods; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects / Q000706:statistics & numerical data; D002921:Cicatrix / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D008727:Methotrexate / Q000008:administration & dosage; D010298:Parity; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014619:Vacuum Curettage / Q000009:adverse effects; D055815:Young Adult
chemical_list: D008727:Methotrexate
keywords: Cesarean scar pregnancy; outcome; suction curettage; urgent surgery