title: Therapeutic effects of uterine artery embolisation (UAE) and methotrexate (MTX) conservative therapy used in treatment of cesarean scar pregnancy.
abstract: OBJECTIVE
  Cesarean scar pregnancy (CSP) is a rare and severe complication after cesarean section. The incidence of CSP has been increased significantly in recent years. In this retrospective case study of 131 CSP patients, the therapeutic effects and prognosis were compared between the two treatment groups: uterine artery embolization and systemic methotrexate injection conservative therapy. In addition, the necessary of subsequent dilation and curettage as a further treatment was also evaluated.
  
  
  METHODS
  The 131 CSP patients were assigned into two groups receiving uterine artery embolization (UAE) or MTX conservative therapy. Based on patients' myometrial thickness and reducing degree of β-hCG level, each of the two treatment group was further divided into two subgroups according to whether the patient received subsequent dilation and curettage as further treatment. The therapeutic effect of two treatment groups was compared.
  
  
  RESULTS
  The results indicated that both UAE and MTX conservative treatment achieved the expected therapeutic effect, and the recovery time in dilation and curettage subgroup was significantly shorter than that of the non-curettage subgroup. One hundred and thirty patients resumed normal menstrual cycles within 3-10 months after the treatment.
  
  
  CONCLUSIONS
  The individualized therapeutic regimen is an important factor to achieve the desired therapeutic effect based on the specific indications. Dilation and curettage could shorten the recovery time significantly.
authors.affiliation: Department of Birth Control, Tianjin Central Hospital of Gynecology Obstetrics, 156 Nankaisan Road, Tianjin, 300100, China. huayangnv86@sina.com.
authors.forename: Hua
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Birth Control, Tianjin Central Hospital of Gynecology Obstetrics, 156 Nankaisan Road, Tianjin, 300100, China.
authors.forename: Shuying
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Birth Control, Tianjin Central Hospital of Gynecology Obstetrics, 156 Nankaisan Road, Tianjin, 300100, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Ma
authors.affiliation: Department of Birth Control, Tianjin Central Hospital of Gynecology Obstetrics, 156 Nankaisan Road, Tianjin, 300100, China.
authors.forename: Yanju
authors.initials: Y
authors.lastname: Jia
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D002921:Cicatrix / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy*; D003131:Combined Modality Therapy; D004107:Dilatation and Curettage / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D055357:Uterine Artery Embolization / Q000009:adverse effects / Q000379:methods*; D014599:Uterus / Q000601:surgery
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate
keywords: Cesarean scar pregnancy; Methotrexate; Uterine arteries embolism