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Archives of Gynecology and Obstetrics

, Volume 297, Issue 4, pp 1059–1066 | Cite as

Characteristics of women with mixed mass formation after evacuation following uterine artery chemoembolization for cesarean scar pregnancy

  • Qiu-Lei Sun
  • Xiao-Hua Wu
  • Li Luo
  • De-Mei Ying
  • Ying Yang
  • Zheng-Qiong Chen
Images in Obstetrics and Gynecology
  • 103 Downloads

Abstract

Purpose

To explore the efficacy of treatment for early cesarean scar pregnancy (CSP) and to evaluate the characteristics of women with subsequent mixed mass formation.

Methods

Women with CSP, who received UACE followed by evacuation, were retrospectively analyzed. Clinical/sonographic characteristics in patients with or without mixed mass formation were compared.

Results

From a total of 395 cases, 105 cases had a pregnancy residual with mixed mass formation. Blood loss and subsequent salvage intervention were significantly lower in patients without mixed mass, although all women retained their uteri. It required 50 days for the mass to resolve, 40 days for β-hCG concentrations to drop back to normal, and 61 days for menses to be restored; all of which were significantly longer than the same indices in women without a mixed mass. Clinical/sonographic characteristics predicting residual mass formation were maximal diameter of gestational sac (OR = 1.05, P = 0.001, with a sensitivity and specificity of 68.6 and 80.3%, respectively), presence of a fetal heart beat (OR = 2.63, P = 0.002, with a sensitivity and specificity of 62.9 and 67.2%, respectively), remnant myometrial thickness (OR = 108.91, P = 0.001 when thickness was less than 1 mm, with a sensitivity and specificity of 42.9% and 96.6%), location of gestational sac (OR = 59.20, P = 0.01 for complete type, with a sensitivity and specificity of 99.0 and 36.9%), and Doppler signal grading (OR = 8.08, P = 0.013 for Grade III, with a sensitivity and specificity of 83.8 and 51.0%).

Conclusions

UACE followed by evacuation was effective for CSP and subsequent mixed mass formation could be predicted by some clinical/sonographic characteristics.

Keywords

Cesarean scar pregnancy Evacuation therapy Uterine artery chemoembolization 

Notes

Acknowledgements

We thank for the ultrasonography team, who provided detailed and accurate sonographic information about the CSP cases.

Author contributions

Z-QC: project development and manuscript editing. Q-LS: manuscript editing. LL: data analysis. D-MY: data collection. XHW: data collection and manuscript writing YY: project development.

Funding

This research was funded by grants from the National Natural Science Foundation of China (No. 81270758).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of the Army Medical University, and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyThe Second Clinical Medical College of Army Medical UniversityChongqingPeople’s Republic of China

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