Treatment of Early Cesarean Scar Pregnancy with Double Balloon Catheter: A Systematic Review of the Literature

IF 0.4 4区 医学 Q4 OBSTETRICS & GYNECOLOGY Clinical and experimental obstetrics & gynecology Pub Date : 2023-10-20 DOI:10.31083/j.ceog5010222
Irene Passerini, Francesco Marasciulo, Federico Prefumo, Anna Fichera, Nicola Fratelli, Filippo Alberto Ferrari, Federico Ferrari, Franco Odicino
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Abstract

Background: Cesarean scar pregnancy (CSP) is a pregnancy in the scar area or “niche” from a prior hysterotomy, usually from a cesarean section. Currently, there is no consensus on the best management of CSP. A recent proposed treatment consists in placing a cervical ripening double-balloon catheter in the uterus under ultrasound guidance. Methods: In this systematic review on cervical ripening double-balloon catheter (CRDBC) treatment for CSP, we performed a literature search in electronic databases (Scopus, PubMed, MEDLINE, and Cochrane Library), from their inception until April 2023. The review was written following PRISMA guidelines for systematic reviews. Results: We identified 30 studies, and we finally analyzed 5 studies that met the inclusion criteria (one case report, two retrospective case series studies, a retrospective cohort study, and a retrospective multicentric case series). The total of pregnancies treated with CRDBC is 71, of which 8 (11%) were cervical pregnancies. The gestational age at treatment ranges from 5 + 0 to 10 + 1 gestational weeks, with variable human chorionic gonadotropin (hCG) levels (433–64.700 IU/mL). Most of the patients (73%) received adjuvant systemic methotrexate (MTX) and the catheter dwell time ranges from 1 to 5 days. Treatment was successful in all the patients. Maternal complications, defined as the need for transfusion, vaginal bleeding resulting in readmission, or requiring further treatment occurred in a small number of patients (4.2%). Conclusions: CRDBC was successful in the treatment of early CSPs. The effectiveness and safety of this minimally invasive method is testified to a small rate of maternal complications. Further prospective studies are warranted to explore this treatment modality. The study was registered on INPLASY (https://inplasy.com/), registration number: INPLASY202390070 (doi: 10.37766/inplasy2023.9.0070).
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双球囊导管治疗早期剖宫产瘢痕妊娠:文献系统回顾
背景:剖宫产瘢痕妊娠(Cesarean scar pregnancy, CSP)是指先前剖宫产后在瘢痕区或“生态位”发生的妊娠,通常来自剖宫产。目前,对CSP的最佳管理尚未达成共识。最近提出的一种治疗方法是在超声引导下在子宫内放置宫颈成熟双球囊导管。方法:在这篇关于宫颈成熟双球囊导管(CRDBC)治疗CSP的系统综述中,我们检索了电子数据库(Scopus、PubMed、MEDLINE和Cochrane Library)从建立到2023年4月的文献。该综述是按照PRISMA系统综述指南编写的。结果:我们确定了30项研究,最终分析了5项符合纳入标准的研究(1例病例报告、2例回顾性病例系列研究、1例回顾性队列研究和1例回顾性多中心病例系列研究)。接受CRDBC治疗的妊娠总数为71例,其中8例(11%)为宫颈妊娠。治疗时的胎龄为5 + 0 ~ 10 + 1胎周,人绒毛膜促性腺激素(hCG)水平变化(433-64.700 IU/mL)。大多数患者(73%)接受了全身甲氨蝶呤(MTX)辅助治疗,导管停留时间为1 ~ 5天。所有病人的治疗都很成功。产妇并发症,定义为需要输血、阴道出血导致再入院或需要进一步治疗,发生在少数患者中(4.2%)。结论:CRDBC治疗早期csp是成功的。这种微创方法的有效性和安全性证明了产妇并发症的低发生率。需要进一步的前瞻性研究来探索这种治疗方式。本研究在INPLASY (https://inplasy.com/)上注册,注册号:INPLASY202390070 (doi: 10.37766/inplasy2023.9.0070)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.50
自引率
0.00%
发文量
241
审稿时长
1 months
期刊介绍: CEOG is an international, peer-reviewed, open access journal. CEOG covers all aspects of Obstetrics and Gynecology, including obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine. All submissions of cutting-edge advances of medical research in the area of women''s health worldwide are encouraged.
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