Management of Cesarean Scar Pregnancy: A Case Series.

Objective: To survey effective treatment strategies for cesarean scar pregnancy (CSP).

Methods: The clinical data of 78 patients diagnosed with CSP from January 2010 to December 2013 were reviewed.

Results: Among these patients, 17 patients were first treated at our hospital; of them, 2 were misdiagnosed. The other 61 patients were referred from other hospitals; of them, 21 were initially misdiagnosed. There were 9 patients who were treated with laparotomy, 50 patients with curettage after uterine artery embolization (UAE) with or without local methotrexate (MTX) infusion, 10 patients with dilatation and curettage, 6 patients with transvaginal sonographic guided local intragestational MTX injection, and 3 patients with systemic MTX injection. All patients finally recovered. Patients with excessive vaginal hemorrhage underwent either emergency UAE treatment or laparotomy. These two treatments had similar success rates (81.82% vs. 100%, χ2 =0.289, P>0.05).

Conclusions: The accurate diagnosis of CSP is important. Curettage after UAE with or without local MTX infusion is a safe and effective method.