The efficacy and prognostic factors of methotrexate treatment in cervical/previous cesarean scar pregnancy.

Park, Joon Cheol; Rhee, Jeong Ho; Kim, Jong In

Original Article

Korean Journal of Obstetrics & Gynecology 2006;49(5):1028-1034.
Published online May 1, 2006.

The efficacy and prognostic factors of methotrexate treatment in cervical/previous cesarean scar pregnancy.

Joon Cheol Park, Jeong Ho Rhee, Jong In Kim

Department of Obstetrics and Gynecology, School of Medicine, Keimyung University, Daegu, Korea. jcpark@dsmc.or.kr

Abstract

OBJECTIVE
To evaluate the efficacy and prognostic factors of methotrexate treatment in cervical/previous cesarean scar pregnancy. METHODS: This study was retrospectively performed in 25 women who had diagnosed cervical/previous cesarean scar pregnancy. Clinical and demographic characteristics, methotrexate regimen, concomitant invasive procedures, complications, and outcomes were analyzed. RESULTS: Among the 25 cases, 64% of women was succeeded by only methotrexate injection, and 96% of women could preserved her fertility after concomitant procedures. There were no significant differences in the patients' age, parity, gestational age and serum beta-hCG, but significant differences in methotrexate administration route and presence of initial hematoma formation between success group and failure group of methotrexate therapy. A concomitant feticide could enhance the therapeutic effect. CONCLUSIONS: The presence of hematoma formation before treatment is important predictor of methotrexate treatment in cervical/previous cesarean scar pregnancy, rather than gestational age, serum beta-hCG. And direct local injection of methotrexate with concomitant feticide procedure could be better route of administration in cervical/previous cesarean scar pregnancy.

Key Words: Cervical/previous cesarean scar pregnancy, Methotrexate