ArticleJournal of clinical medicine2023
"In Situ" Methotrexate Injection Followed by Hysteroscopic Resection for Caesarean Scar Pregnancy: A Single-Center Experience.
Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 6 citations in OpenAlex.
- A Possible Role of Clinical Factors in Choosing the Best Treatment Modality in Cesarean Scar Pregnancy.Diagnostics (Basel, Switzerland) · 2025Article
- Comparative Analysis of the Efficacy of Four Different Surgical Modalities in the Treatment of Cesarean Scar Pregnancy: A Multicenter Retrospective Study.Advances in therapy · 2025Article
- Analysis of reproductive outcomes after cesarean scar pregnancy surgery: a multicenter retrospective study.Frontiers in medicine · 2025Article
- Scar Pregnancy: A Rare, but Challenging, Obstetric Condition.Journal of clinical medicine · 2023Article
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe evaluated the efficacy of local methotrexate (MTX) treatment followed by hysteroscopic resection for caesarean scar pregnancy and its impact on future fertility.
methodsMonocentric, prospective, observational study performed in the Haykel Hospital between June 2016 and December 2020. Twenty-one women with caesarean scar pregnancy underwent a transcutaneous ultrasound-guided direct injection of MTX into the gestational sac in an outpatient setting. Hysteroscopic resection of residual trophoblastic retention was then performed according to perisaccular blood flow. MAIN
resultsTwo patients had complete spontaneous trophoblast expulsion after MTX injection, and hysteroscopy was performed in 19 patients for residual trophoblastic retention 1 to 12 weeks after MTX injection. Successful preservation of a healthy uterus with the combined procedure was obtained in 94.8% of patients. Hemostatic hysterectomy was required in one patient. Mean hospitalization duration was 1.5 days. Three patients had spontaneous pregnancy after the procedure.
conclusionDirect MTX injection into the gestational sac for caesarean scar pregnancy followed by hysteroscopic resection was an effective technique with a short hospitalization, fertility preservation and a low major complication rate compared with other modalities of treatment reported in the literature. Further larger prospective comparative studies are needed to confirm the efficacy of this procedure.
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