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Research Article
Xiaorong Qi
West China Second University Hospital of Sichuan University
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: Prophylactic uterine artery embolization (UAE) combined with following curettage was suggested as an effective and minimally invasive treatment strategy for cesarean scar pregnancy (CSP) with high bleeding risk. However, the timing of curettage after UAE remains to be studied. Thus, we aimed to identify the optimal time interval to perform curettage after UAE in patients with CSP.
Methods: We conducted a retrospective cohort study in a large medical center for women and children in southwest China. CSP patients treated by UAE combined with following curettage were included and grouped by the treatment time interval between these two procedures. The clinical outcomes among arms were compared by univariate and multi-variable analysis.
Results: Our study finally included a total of 314 CSP patients who received this combination treatment in our department from January 2014 to December 2019. The median time interval between UAE and curettage was 48 hours with a range of 12-168 hours in all participants. Thirty-two cases (10.2%) experienced intra-operative hemorrhage (blood loss ≥200mL). Seventeen cases (5.4%) used intrauterine balloon tamponade. Fourteen cases (4.5%) were converted into laparoscopy (or laparotomy). In the cohort study, patients with longer treatment interval had more intra-operative blood loss and higher incidence of complications than those with shorter interval (P＜0.05). The rate of intra-operative bleeding was 5.0% in patients who received curettage within 24 hours after UAE (Arm 1), in comparison with 19.4% in those who had treatment interval longer than 72 hours (Arm 4). In the multi-variable logistic regression model of bleeding, the treatment interval ＞72 hours had an adjusted odds ratio of 3.37 (95% confidence interval: 1.40-8.09).
Conclusion: We suggest that curettage should not be delayed longer than 72 hours after UAE under general conditions.
Keywords
Cesarean scar pregnancy, uterine artery embolization, curettage, treatment interval, hemorrhage
Figure 1
Figure 2
No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
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CURRENT STATUS: Under Review
Version 1
Posted 15 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 05 Apr, 2021
Reviews received
Received 06 Mar, 2021
Reviewers agreed
On 26 Feb, 2021
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Editor assigned
On 26 Feb, 2021
Editor invited
On 10 Feb, 2021
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On 10 Feb, 2021
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Subject Areas
Maternal & Fetal Medicine
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This preprint is under consideration at BMC Pregnancy and Childbirth. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Xiaorong Qi
West China Second University Hospital of Sichuan University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 15 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 05 Apr, 2021
Reviews received
Received 06 Mar, 2021
Reviewers agreed
On 26 Feb, 2021
Reviewers invited
Invitations sent on 26 Feb, 2021
Editor assigned
On 26 Feb, 2021
Editor invited
On 10 Feb, 2021
Submission checks complete
On 10 Feb, 2021
First submitted
On 31 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Prophylactic uterine artery embolization (UAE) combined with following curettage was suggested as an effective and minimally invasive treatment strategy for cesarean scar pregnancy (CSP) with high bleeding risk. However, the timing of curettage after UAE remains to be studied. Thus, we aimed to identify the optimal time interval to perform curettage after UAE in patients with CSP.
Methods: We conducted a retrospective cohort study in a large medical center for women and children in southwest China. CSP patients treated by UAE combined with following curettage were included and grouped by the treatment time interval between these two procedures. The clinical outcomes among arms were compared by univariate and multi-variable analysis.
Results: Our study finally included a total of 314 CSP patients who received this combination treatment in our department from January 2014 to December 2019. The median time interval between UAE and curettage was 48 hours with a range of 12-168 hours in all participants. Thirty-two cases (10.2%) experienced intra-operative hemorrhage (blood loss ≥200mL). Seventeen cases (5.4%) used intrauterine balloon tamponade. Fourteen cases (4.5%) were converted into laparoscopy (or laparotomy). In the cohort study, patients with longer treatment interval had more intra-operative blood loss and higher incidence of complications than those with shorter interval (P＜0.05). The rate of intra-operative bleeding was 5.0% in patients who received curettage within 24 hours after UAE (Arm 1), in comparison with 19.4% in those who had treatment interval longer than 72 hours (Arm 4). In the multi-variable logistic regression model of bleeding, the treatment interval ＞72 hours had an adjusted odds ratio of 3.37 (95% confidence interval: 1.40-8.09).
Conclusion: We suggest that curettage should not be delayed longer than 72 hours after UAE under general conditions.
Figure 1
Figure 2
No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
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