title: Randomized controlled trial of hysteroscopy or ultrasonography versus no guidance during D&C after uterine artery chemoembolization for cesarean scar pregnancy.
abstract: OBJECTIVE
  To compare the complication rates after uterine artery chemoembolization (UACE) followed by dilation and curettage (D&C) guided by different types of monitoring for treatment of cesarean scar pregnancy (CSP).
  
  
  METHODS
  A randomized controlled trial was undertaken of women with CSP attending a hospital in Wuhan, China, between June 1, 2010, and June 30, 2014. Using sealed opaque envelopes containing random numbers, participants were randomly allocated to undergo D&C with hysteroscopy monitoring, ultrasonography monitoring, or no monitoring. Participants and investigators were masked to group assignment. The primary outcome was the number of participants with complications at 2 months of follow-up after D&C. Analyses were by intention to treat.
  
  
  RESULTS
  Among 144 participants, 48 were assigned to hysteroscopy monitoring, 44 to ultrasonography monitoring, and 52 to no monitoring. Complications were noted for 1 (2.1%) patient in the hysteroscopy group, 2 (4.5%) in the ultrasonography group, and 12 (23.1%) in the no monitoring group (P=0.001).
  
  
  CONCLUSIONS
  Hysteroscopy or ultrasonography monitoring of D&C after UACE for CSP treatment can decrease the complication rate. ClinicalTrials.gov: NCT02357095.
authors.affiliation: Maternal and Child Health Hospital of Hubei Province, Wuhan, China.
authors.forename: Yanli
authors.initials: Y
authors.lastname: Li
authors.affiliation: Maternal and Child Health Hospital of Hubei Province, Wuhan, China.
authors.forename: Liyan
authors.initials: L
authors.lastname: Gong
authors.affiliation: Maternal and Child Health Hospital of Hubei Province, Wuhan, China.
authors.forename: Xufeng
authors.initials: X
authors.lastname: Wu
authors.affiliation: Maternal and Child Health Hospital of Hubei Province, Wuhan, China. Electronic address: 52109123@qq.com.
authors.forename: Han
authors.initials: H
authors.lastname: Gao
authors.affiliation: Department of Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Hongbing
authors.initials: H
authors.lastname: Zheng
authors.affiliation: Maternal and Child Health Hospital of Hubei Province, Wuhan, China.
authors.forename: Weishun
authors.initials: W
authors.lastname: Lan
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D002681:China; D002921:Cicatrix / Q000209:etiology; D004107:Dilatation and Curettage / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000601:surgery*; D011446:Prospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D014463:Ultrasonography; D055357:Uterine Artery Embolization / Q000379:methods*; D014592:Uterine Hemorrhage / Q000453:epidemiology; D055815:Young Adult
chemical_list: D008727:Methotrexate
keywords: Cesarean scar pregnancy; Hysteroscopy monitoring; Ultrasonography monitoring; Uterine artery chemoembolization