Bilateral uterine artery chemoembolization combined with dilation and curettage for treatment of cesarean scar pregnancy: A method for preserving the uterus

Aim The aim of this study was to respectively evaluate the feasibility and safety of bilateral uterine artery chemoembolization (UACE) combined with dilation and curettage (D&C) for the treatment of cesarean scar pregnancy (CSP). Material and Methods Our study was approved by our institutional review board, with informed patient consent. From January 2004 to December 2010, 79 patients with CSP underwent UACE in our institution, with transcatheter infusion of 30-50mg methotrexate into the bilateral uterine artery before embolization with sponge particles. Within 24-48h after UACE, D&C was performed on all the patients under the guidance of ultrasonography and hysteroscopy. Results All the 79 patients diagnosed as having CSP were included in our study and their data were analyzed. All the patients recovered completely without severe complications. The average hemorrhage volume during D&C was 30mL, but none of them needed transfusion. The uteri of all the patients were preserved, and none of them had to undergo hysterectomy. The safety rate was 100%. The mean duration of hospital stay was 10.5 days. Conclusions UACE performed prior to D&C is a feasible method and it may reduce hemorrhage complications and risk of hysterectomy in patients with CSP.