Purpose: To compare the efficacy and safety of uterine artery embolization (UAE) combined with curettage and methotrexate (MTX) plus curettage in the treatment of cesarean scar pregnancy (CSP).
Methods: From January 2005 to December 2013, we treated 38 CSP patients with UAE combined with curettage, and another 26 patients with CSP were treated with methotrexate (MTX) plus curettage. The resulting data were analyzed statistically.
Results: The median volume of blood loss was 17.5 ml in the UAE combined with curettage (UAE-C) group vs. 335 ml in the MTX plus curettage (MTX-C) group (p < 0.001). The time from the procedure till β-human chorionic gonadotropin (β-hCG) concentration returned to normal was 25.13 ± 3.74 days in the UAE-C group vs. 56.15 ± 15.99 days in the MTX-C group (p < 0.001). The duration of hospitalization was 7.44 ± 1.92 vs. 19.38 ± 8.75 days, respectively (p < 0.001). The percentage of side effects in the UAE-C group was significantly lower than in the MTX-C group.
Conclusions: UAE combined with curettage appears to be superior to MTX plus curettage for treatment of CSP with high serum β-hCG level, though prospective trials are needed.
Keywords: Cesarean scar pregnancy; Curettage; Methotrexate; Treatment; Uterine artery embolization.