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Multicenter Study
. 2022 Dec;127(12):1313-1321.
doi: 10.1007/s11547-022-01536-y. Epub 2022 Sep 27.

Endovascular treatment of cesarean scar pregnancy: a retrospective multicentric study

Giovanni Failla  1 , Federica Libra  2 , Francesco Giurazza  3 , Nicola Maria Lucarelli  4 , Giovanni Coniglio  5 , Francesco Vacirca  2 , Serafino Maria Santonocito  5 , Cristian Dell'Atti  4 , Francesco Camerano  5 , Stefano Palmucci  2 , Raffaella Niola  3 , Antonio Basile  2 , Domenico Patanè  5
Affiliations
Multicenter Study

Endovascular treatment of cesarean scar pregnancy: a retrospective multicentric study

Giovanni Failla et al. Radiol Med. 2022 Dec.

Abstract

Purpose: To assess the role of Uterine Artery Embolization (UAE) to treat cesarean scar pregnancy (CSP) using different embolic materials, focusing on its clinical and technical success rates; the association of UAE with methotrexate (MTX) and/or dilatation & curettage (D&C) was evaluated also.

Materials and methods: A retrospective analysis 33 patients (mean age 35 years) affected by CSP and treated with UAE from March 2012 to 2020 was performed. Dynamic levels of serum β-HCG have been collected until they decreased to normal values after procedures. For the statistical analysis the sample was divided into 2 groups: UAE versus UAE + MTX.

Results: The gestational sac age ranged between 5 and 13 weeks (mean 7 weeks). According to operator's preference, 11 patients (33.33%) were treated with sponge injection, 2 patients (6.06%) with a combination of sponge and microsphere the remaining 20 patients (60.60%) with microspheres alone. No major complications occurred after UAE and D&C, neither side effects related to the MTX administration. Technical and clinical success rates were 97% and 85%, respectively. Mean percentage of β-HCG reduction was 90% (range - 99.92 to + 7.98%). Statistical analysis with linear regression shows a R2 value of 0.9624 in UAE group while a R2 value of 0.9440 in UAE + MTX group with statistical significance (p < 0.0001). No significative differences were found between the two groups about clinical success rate and embolic material adopted.

Conclusion: In this series UAE has been found to be safe and effective for the treatment of CSP.

Keywords: Angiography; Dilation and curettage; Ectopic pregnancy; Scar pregnacy; Ultrasound; Uterine artery embolization.

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References

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