Uterine artery embolization compared with methotrexate for the management of pregnancy implanted within a cesarean scar.

Objective: The objective of the study was to compare the efficacy and safety of uterine artery embolization (UAE) vs systemic methotrexate (MTX) for pregnancy within a cesarean scar.

Methods: Seventy-two women with pregnancy within cesarean scar were randomly allocated to a UAE group (37 cases) or an MTX group (35 cases), which all was followed by suction curettage. The primary outpoints include bleeding loss, serum beta-human chorionic gonadotropin level, and side effects.

Results: The bleeding volumes were 36.93 +/- 6.01 mL in the UAE group and 415.63 +/- 68.37 mL in the MTX group (P < .001). The hospitalization time was 11.73 +/- 0.80 days in the UAE group and 39.63 +/- 4.57 days in the MTX group (P < .001). There was no severe side effect in both groups.

Conclusions: For pregnancy within a cesarean scar, UAE followed by suction curettage appears to have more advantage and may be a priority option.