ORIGINAL ARTICLE |
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Year : 2019 | Volume
: 8
| Issue : 1 | Page : 12-18 |
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Management of cesarean scar pregnancy among vietnamese women
Tuan Minh Vo1, Thong Van2, Long Nguyen2, Quynh Tran2
1 Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam 2 Department of Gynecology, Tudu Hospital, Ho Chi Minh City, Vietnam
Correspondence Address:
Dr. Tuan Minh Vo Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, No. 217 Hong Bang, District 5, Ho Chi Minh City Vietnam
 Source of Support: None, Conflict of Interest: None  | 5 |
DOI: 10.4103/GMIT.GMIT_8_18
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Objective: To demonstrate the efficacy of management for cesarean scar ectopic pregnancies up to 8 weeks' gestation using ultrasound-guided Foley balloon catheter placement combined with dilation and curettage (D and C) at TuDu Hospital.
Subjects and Methods: A quasi-experimental study was conducted from March 2015 to March 2016. Patients with imaging-confirmed cesarean ectopic pregnancies were admitted to an inpatient unit at Tu Du Hospital. A Foley balloon catheter was placed inside the uterus under ultrasound guidance and was left in place for 24 h. Afterward, the patient underwent ultrasound-guided D and C. Follow-up to confirm success included serial blood draws to measure beta-human chorionic gonadotropin (β-hCG) levels until a value of 0, and routine ultrasounds to confirm absence of a gestational sac and no evidence of vascularity at the site of the cesarean section scar.
Results: A total of 311 patients were enrolled over 3 months. Overall, 90.7% (95% confidence interval [CI]: 86.8%–93.9%) patients were successfully treated with this regimen. Several factors that were significantly associated with successful management included gestational age <6 weeks (odds ratio [OR] 3.1, 95% CI: 1.03%–8.76%), β-hCG level <11,000 mUI/mL before discharge from the hospital (OR 6.5, 95% CI: 1.42%–30.6%), gestational sac volume 2 weeks after treatment measuring <5 cm3 (OR 9.1, 95% CI: 1.96%–50.1%).
Conclusions: This is an easily applicable method with a short follow-up period and reduction in treatment costs compared to standard treatment with methotrexate injection.
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