title: Efficacy comparison of transcatheter arterial embolization with gelatin sponge and polyvinyl alcohol particles for the management of cesarean scar pregnancy and follow-up study.
abstract: OBJECTIVE
  The aim of this study was to compare the therapeutic efficacy of transcatheter arterial embolization (TAE) with gelatin sponge (GS) and polyvinyl alcohol (PVA) particles for cesarean scar pregnancy (CSP).
  
  
  METHODS
  A total of 35 patients with CSP, who were classified into either the GS group (n = 22) or the PVA group (n = 13), underwent TAE and postoperative ultrasound-guided curettage. Their hospital stay, first-scheme success rate, intra-curettage blood loss, serum β-human chorionic gonadotropin (hCG) level, and other indicators were simultaneously recorded. During the follow-up period, time for the serum β-hCG level to return to normal, time for the return of menstrual cycle, and menstrual blood volume were recorded.
  
  
  RESULTS
  Compared with the GS group, patients in the PVA group: (i) were older; (ii) had greater number of abortions or curettages, and had longer times since last cesarean (P < 0.05); (iii) had similar hospital stay and first-scheme success rate (P > 0.05); (iv) had lower, but not significantly different, hemorrhage rate (7.7% vs 36.4%, P = 0.066); (v) had a significantly higher serum β-hCG level at discharge and a smaller drop in serum β-hCG level from admission to discharge (P < 0.05); (vi) had a similar time for the serum β-hCG level to return to normal (P > 0.05); (vii) had a shorter time for the return of menstrual cycle (P = 0.012); and (viii) had a significantly higher incidence of abnormal menstrual blood volume reduction (50.0% vs 8.3%, P = 0.034).
  
  
  CONCLUSIONS
  TAE with either GS or PVA particles for CSP treatment had relatively good efficacy. During the selection of the ideal embolic agent, the patient's age, hemorrhage risk, and requirement for protecting ovarian function and reserving fertility should be comprehensively considered.
authors.affiliation: Departments of Gynecology, The Third Affiliated Hospital of Soochow University, Changzhou, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.
authors.forename: Xiaonan
authors.initials: X
authors.lastname: Shao
mesh_terms: D000328:Adult; D000818:Animals; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D005780:Gelatin / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011142:Polyvinyl Alcohol / Q000627:therapeutic use*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000628:therapy*; D055357:Uterine Artery Embolization / Q000379:methods*; D055815:Young Adult
chemical_list: D005780:Gelatin; D011142:Polyvinyl Alcohol
keywords: cesarean scar pregnancy; gelatin sponge; polyvinyl alcohol; transcatheter arterial embolization