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Gynecol Minim Invasive Ther. 2019 Jan-Mar;8(1):12-18. doi: 10.4103/GMIT.GMIT_8_18. Epub 2019 Jan 23.

Management of Cesarean Scar Pregnancy among Vietnamese Women.

Author information

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.

Abstract

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.

KEYWORDS:

Cesarean scar pregnancy; Foley ballon catheter; Vietnam; dilation and curettage

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