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The Scientific World Journal
Volume 2013, Article ID 213603, 6 pages
http://dx.doi.org/10.1155/2013/213603
Clinical Study

The Analysis of Efficacy and Failure Factors of Uterine Artery Methotrexate Infusion and Embolization in Treatment of Cesarean Scar Pregnancy

Department of Vascular Surgery and Interventional Radiology, Shanghai First People’s Hospital, School of Medicine, Shanghai Jiao Tong University, No. 100 HaiNing Road, HongKou District, Shanghai 200080, China

Received 22 August 2013; Accepted 16 September 2013

Academic Editors: A. Kelekis and R. Worthington-Kirsch

Copyright © 2013 Xiao An et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. This study observes therapeutic efficacy of uterine artery embolization combined with MTX infusion which terminates cesarean scar pregnancy (CSP) and induces three factors which probably relate to failure. Methods. Twenty-three CSP patients were treated with combined uterine artery MTX infusion and embolization. Among them six patients with severe hemorrhage were immediately treated with interventional operation. Clinical effects were estimated by symptoms, serum -hCG, ultrasound, and MR. Results. Interventional treatments were technologically successful in 22 patients except one. Immediate hemostasis was achieved in all 6 patients with massive colporrhagia. No occurrence of infection and uterine necrosis was observed, but 12 women suffered abdominal pains. Nineteen patients’ uteri were preserved, whereas four underwent hysterectomy eventually. Conclusions. Transcatheter arterial chemoembolization is effective to treat high-risk CSP in preference to hysterectomy. To achieve more successful outcomes, three factors should be highlighted: adequate MTX dosage, appropriate embolic material, and complete embolization of target arteries that supply blood to embryo in the scar.