Retrospective study of patients with cesarean scar pregnancies treated by uterine artery chemoembolization and curettage.

OBJECTIVE

To evaluate the efficacy and long-term prognosis of uterine artery chemoembolization (UACE) combined with curettage for treatment of cesarean scar pregnancy (CSP).

METHODS

Data were retrospectively reviewed from women with CSPs treated by UACE with curettage at Women's Hospital of Zhejiang University, Hangzhou, a tertiary obstetrics and gynecologic center in China, between December 2006 and December 2016. Information on clinical characteristics and treatment outcomes was obtained from medical records and follow-up interviews.

RESULTS

There were 383 patients included; 379 (99.0%) women were successfully treated. Risk factors associated with intraoperative bleeding were size of gestational mass (P=0.001), presence of fetal heart beat (P=0.002), and type of CSP (P=0.002). Among 301 women with complete medical records over a mean ± SD follow-up of 49.8 ± 30.2 months, 164 (54.5%) women resumed normal menstruation and only 22 (7.3%) experienced a reduction in menstrual volume of more than one-half. Among 89 women attempting to conceive, the conception rate was 69% (61/89), the positive pregnancy rate was 80% (49/61), and 35 live neonates were delivered.

CONCLUSION

UACE combined with curettage was found to be an effective fertility-sparing treatment for CSP. Further, the approach did not seem to harm future reproductive ability.