Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jan 27:11:137-42.
doi: 10.2147/TCRM.S76050. eCollection 2015.

Comparative efficacy and safety of local and systemic methotrexate injection in cesarean scar pregnancy

Ping Peng  1 , Ting Gui  1 , Xinyan Liu  1 , Weilin Chen  1 , Zhenzhen Liu  2
Affiliations

Comparative efficacy and safety of local and systemic methotrexate injection in cesarean scar pregnancy

Ping Peng et al. Ther Clin Risk Manag. .

Abstract

Objective: To investigate the efficacy of methotrexate (MTX) injection in treatment of cesarean scar pregnancy (CSP).

Method: A randomized controlled study was performed in 104 CSP patients receiving either local or systemic MTX injection at the Peking Union Medical College Hospital from the year 2008 to 2013.

Results: Complete cure was defined as regression of ultrasonographic findings and normalization of serum β-hCG within 60 days. It was regarded as delayed cure if additional dilation and curettage (D&C) was needed. The overall cure rate (complete cure plus delayed cure) was 69.2% versus 67.3% for local injection versus systemic administration (P>0.05). The median time for serum β-hCG remission and uterine mass disappearance after systemic administration (42 [21-69] days and 40 [20-67] days) were significantly lower than those receiving local injection (56 [24-92] days and 53 [23-88] days), with P=0.029 and 0.046, respectively. The mean pretreatment serum β-hCG (human chorionic gonadotropin) level and lesion size in cured group (21,941±18,351 mIU/mL and 2.9±1.3 cm, respectively) were significantly lower than those in the failed group (37,047±30,864 mIU/mL and 3.6±1.3) with P=0.038 and 0.044, respectively.

Conclusion: MTX injection is effective in CSP treatment. Systemic administration shows similar overall cure rate compared to local injection, but requires shorter time for serum β-hCG remission and uterine mass disappearance.

Keywords: cesarean scar pregnancy; local; methotrexate injection; systemic.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Consort flow diagram.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Jurkovic D, Hillaby K, Woelfer B, Lawrence A, Salim R, Elson CJ. First trimester diagnosis and management of pregnancies implanted into the lower uterine segment cesarean section scar. Ultrasound Obstet Gynecol. 2003;21:220–227. - PubMed
    1. Jurkovic D, Hillaby K, Woelfer B, Lawrence A, Salim R, Elson CJ. Cesarean scar pregnancy. Ultrasound Obstet Gynecol. 2003;21:310. - PubMed
    1. Timor-Tritsch IE, Monteagudo A, Santos R, Tsymbal T, Pineda G, Arslan AA. The diagnosis, treatment, and follow-up of cesarean scar pregnancy. Am J Obstet Gynecol. 2012;207:44.e1–13. - PubMed
    1. Timor-Tritsch IE, Monteagudo A. Unforeseen consequences of the increasing rate of cesarean deliveries: early placenta accreta and cesarean scar pregnancy. A review. Am J Obstet Gynecol. 2012;207:14–29. - PubMed
    1. Litwicka K, Greco E. Cesarean scar pregnancy: a review of management options. Curr Opin Obstet Gynecol. 2011;23:415–421. - PubMed