title: Uterine artery embolization with and without local methotrexate infusion for the treatment of cesarean scar pregnancy.
abstract: OBJECTIVE
  To compare the clinical value of uterine artery embolization (UAE) with local methotrexate (MTX) infusion to embolization without MTX in the treatment of cesarean scar pregnancies (CSPs).
  
  
  METHODS
  From January 2009 to December 2013, 50 patients with CSP treated with UAE receiving or not receiving local MTX infusion prior to curettage were analyzed retrospectively. Twenty-two patients were offered UAE with local MTX infusion prior to curettage (UAE + MTX group), whereas 28 patients received UAE alone prior to curettage (UAE group). Clinical data and the outcomes were analyzed, followed by a brief review of the published literature summarizing what is known about UAE with and without MTX for the treatment of CSP.
  
  
  RESULTS
  UAE was successful in 42 of 50 cases (84%), with complications occurring in only five patients. There were no significant differences in the success rate, complication rate, recovery time, or hospitalization costs between the UAE + MTX group and the UAE group. However, blood loss in the UAE + MTX group was significantly higher than in the UAE group.
  
  
  CONCLUSIONS
  UAE with or without local MTX infusion might be an effective treatment for CSP. Compared with UAE alone, UAE with local MTX infusion did not dramatically improve the therapeutic effect of UAE. A larger and more comprehensive random control study is warranted to better evaluate the therapeutic effects of UAE in the treatment of CSP.
authors.affiliation: Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Affiliated with Wenzhou Medical College, Linhai, Zhejiang Province, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Qi
authors.affiliation: Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Affiliated with Wenzhou Medical College, Linhai, Zhejiang Province, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhou
authors.affiliation: Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Affiliated with Wenzhou Medical College, Linhai, Zhejiang Province, China.
authors.forename: Mei-Fen
authors.initials: MF
authors.lastname: Wang
authors.affiliation: Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Affiliated with Wenzhou Medical College, Linhai, Zhejiang Province, China.
authors.forename: Ze-Ying
authors.initials: ZY
authors.lastname: Chai
authors.affiliation: Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Affiliated with Wenzhou Medical College, Linhai, Zhejiang Province, China. Electronic address: yshy304@126.com.
authors.forename: Ling-Zhi
authors.initials: LZ
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000792:Angiography / Q000379:methods; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods; D016009:Chi-Square Distribution; D002921:Cicatrix / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy*; D004107:Dilatation and Curettage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D036502:Infusions, Intralesional; D008727:Methotrexate / Q000008:administration & dosage*; D011247:Pregnancy; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014463:Ultrasonography; D055357:Uterine Artery Embolization / Q000009:adverse effects / Q000379:methods*
chemical_list: D008727:Methotrexate
keywords: cesarean scar pregnancy; curettage; methotrexate; uterine artery embolization