Successful management of cesarean scar pregnancy with vacuum extraction under ultrasound guidance

AimCesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy. The gestational sac is implanted in the myometrium at the site of a previous cesarean section. Mothers with CSP are faced with risks of unpredictable massive bleeding or more fatal complications. The purpose of this retrospective study was to assess the feasibility, efficacy, and reliability of the intraoperative ultrasound-guided vacuum aspiration method as an effective treatment option for CSP. MethodsWe undertook a retrospective analysis of CSP patients who had undergone the vacuum aspiration method, by reviewing patient records from the period October 2015 to January 2018. All of the operations were carried out under general anesthesia, with patients in the lithotomy position, using suprapubic ultrasonography guidance. A vacuum aspirator was used to aspirate the whole pregnancy material without perforating the previous cesarean section scar. ResultsTen women with CSP were managed successfully by ultrasound-guided vacuum extraction without complications or further interventions, such as reoperation or methotrexate administration. Three of the 10 patients needed uterine Foley catheter tampon (50cc) for 4h after vacuum extraction alone was applied. During the study period, two additional patients who did not meet the criteria for the vacuum extraction method alone were managed with methotrexate plus vacuum application. Because of the rarity of the condition, the majority of CSPs are case reports or small case series reported in published works, with no consensus on the preferred course of treatment. ConclusionThe vacuum extraction method seems to be a good and practical way of treating CSP. Comparisons of efficacy should be undertaken but large sample sizes are required. We hope this study brings a new perspective for larger sample-sized studies, considering the technique is feasible and applicable.

Yazar Sel, Goerker
Sucu, Sadun
Harma, Muge
Harma, Mehmet Ibrahim
Yayın Türü Article
Tek Biçim Adres https://hdl.handle.net/20.500.12628/3389
Tek Biçim Adres 10.1002/ams2.362
Konu Başlıkları cannula
cesarean scar
cesarean scar pregnancy
ectopic pregnancy
vacuum extraction
Koleksiyonlar Araştırma Çıktıları | WoS | Scopus | TR-Dizin | PubMed | SOBİAD
PubMed İndeksli Yayınlar Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu
Dergi Adı ACUTE MEDICINE & SURGERY
Dergi Cilt Bilgisi 5
Dergi Sayısı 4
Sayfalar 358 - 361
Yayın Yılı 2018
Eser Adı
[dc.title]
Successful management of cesarean scar pregnancy with vacuum extraction under ultrasound guidance
Yazar
[dc.contributor.author]
Sel, Goerker
Yazar
[dc.contributor.author]
Sucu, Sadun
Yazar
[dc.contributor.author]
Harma, Muge
Yazar
[dc.contributor.author]
Harma, Mehmet Ibrahim
Yayın Yılı
[dc.date.issued]
2018
Yayıncı
[dc.publisher]
WILEY
Yayın Türü
[dc.type]
article
Özet
[dc.description.abstract]
AimCesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy. The gestational sac is implanted in the myometrium at the site of a previous cesarean section. Mothers with CSP are faced with risks of unpredictable massive bleeding or more fatal complications. The purpose of this retrospective study was to assess the feasibility, efficacy, and reliability of the intraoperative ultrasound-guided vacuum aspiration method as an effective treatment option for CSP. MethodsWe undertook a retrospective analysis of CSP patients who had undergone the vacuum aspiration method, by reviewing patient records from the period October 2015 to January 2018. All of the operations were carried out under general anesthesia, with patients in the lithotomy position, using suprapubic ultrasonography guidance. A vacuum aspirator was used to aspirate the whole pregnancy material without perforating the previous cesarean section scar. ResultsTen women with CSP were managed successfully by ultrasound-guided vacuum extraction without complications or further interventions, such as reoperation or methotrexate administration. Three of the 10 patients needed uterine Foley catheter tampon (50cc) for 4h after vacuum extraction alone was applied. During the study period, two additional patients who did not meet the criteria for the vacuum extraction method alone were managed with methotrexate plus vacuum application. Because of the rarity of the condition, the majority of CSPs are case reports or small case series reported in published works, with no consensus on the preferred course of treatment. ConclusionThe vacuum extraction method seems to be a good and practical way of treating CSP. Comparisons of efficacy should be undertaken but large sample sizes are required. We hope this study brings a new perspective for larger sample-sized studies, considering the technique is feasible and applicable.
Açıklama
[dc.description]
WOS: 000446055200010
Açıklama
[dc.description]
PubMed: 30338082
Kayıt Giriş Tarihi
[dc.date.accessioned]
2019-12-23
Açık Erişim Tarihi
[dc.date.available]
2019-12-23
Yayın Dili
[dc.language.iso]
eng
Konu Başlıkları
[dc.subject]
cannula
Konu Başlıkları
[dc.subject]
cesarean scar
Konu Başlıkları
[dc.subject]
cesarean scar pregnancy
Konu Başlıkları
[dc.subject]
ectopic pregnancy
Konu Başlıkları
[dc.subject]
vacuum extraction
Haklar
[dc.rights]
info:eu-repo/semantics/openAccess
ISSN
[dc.identifier.issn]
2052-8817
İlk Sayfa Sayısı
[dc.identifier.startpage]
358
Son Sayfa Sayısı
[dc.identifier.endpage]
361
Dergi Adı
[dc.relation.journal]
ACUTE MEDICINE & SURGERY
Dergi Sayısı
[dc.identifier.issue]
4
Dergi Cilt Bilgisi
[dc.identifier.volume]
5
Tek Biçim Adres
[dc.identifier.uri]
https://dx.doi.org/10.1002/ams2.362
Tek Biçim Adres
[dc.identifier.uri]
https://hdl.handle.net/20.500.12628/3389
Görüntülenme Sayısı ( Şehir )
Görüntülenme Sayısı ( Ülke )
Görüntülenme Sayısı ( Zaman Dağılımı )
Görüntülenme
6
09.12.2022 tarihinden bu yana
İndirme
1
09.12.2022 tarihinden bu yana
Son Erişim Tarihi
18 Ocak 2024 15:26
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Tıklayınız
vacuum extraction patients method pregnancy treatment period retrospective methotrexate efficacy ultrasound-guided complications without managed previous cesarean section aspiration Because reports majority condition rarity application AimCesarean needed uterine catheter tampon (50cc) criteria applied During additional series
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