The clinical efficacy of dilatation and evacuation therapy for cesarean scar pregnancy.

Yang, Jeong In; Park, Mi Ae; Chang, Suk Joon; Kim, Haeng Soo

doi:2011.54.8.406

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Original Article

Korean Journal of Obstetrics & Gynecology 2011;54(8):406-412.
DOI: https://doi.org/10.5468/KJOG.2011.54.8.406 Published online August 1, 2011.

The clinical efficacy of dilatation and evacuation therapy for cesarean scar pregnancy.

Jeong In Yang, Mi Ae Park, Suk Joon Chang, Haeng Soo Kim

Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea. yangji@ajou.ac.kr

Abstract

OBJECTIVE
To evaluate the therapeutic efficacy of dilatation and evacuation (D&E) for cesarean scar pregnancy (CSP) and to determine prognostic factors. METHODS: This study was retrospectively performed in 68 women who had been diagnosed with CSP. The 56 CSP women were enrolled for whom D&E was the primary treatment. The patients were divided into two groups according to treatment outcomes. Women who received D&E only were defined as the success group and patients who required additional treatment were categorized as the failure group. Demographic, clinical, and sonographic characteristics according to treatment results were analyzed. RESULTS: Among the total of 56, 36 (64%) women were treated by D&E only, and 20 (36%) women underwent additional treatments. There were no significant difference in maternal age, gravida, number of previous cesarean section, initial symptoms, but significant difference in parity (> or =2), gestational age at diagnosis, serum beta-human chorionic gonadotropin level, postoperative stay, and time to resolution was present (P <0.05). On sonographic findings, there was significant difference in terms of fetal heart beat, hematoma and myometrial thickness of the implantation site (P <0.05). After multivariate regression, only myometrial thickness of the implantation site with a cut-off value of 1.75 mm was significant. CONCLUSION: D&E is an effective and safe treatment modality in selected cases of CSP. Consideration of prognostic factors before deciding treatment modalities can help to achieve better outcomes.

Key Words: Cesarean scar pregnancy, Dilatation and evacuation, Treatment

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