The comparison of time interval between methotrexate use and curettage in cesarean scar pregnancy complication

Abstract

With the increase in the incidence of cesarean section, the subsequent risks such as ectopic pregnancy (EP) have also increased. One type of these pregnancies is scar ectopic pregnancy (CSP) or incisional pregnancy, which carries significant risks for the mother. To date, limited research has directly compared the effect of time interval between methotrexate administration and curettage on complications in the treatment of incisional pregnancy. Therefore, this clinical trial was conducted with the aim of comparing the effect of a time interval of less than 48 hours and from 48 hours to 7 days between the administration of methotrexate and curettage on the complications of scar pregnancy treatment. Methods: In this clinical trial, 15 women over the age of 18 who had an incisional pregnancy and referred to the Alzahra Medical Training Center in Tabriz were included in this study. Fifteen women with the same condition treated in this center were retrospectively included in the control group. Patients in the case group underwent curettage between 48 hours and 7 days and in the control group less than 48 hours after methotrexate intravenous injection, and the complications of curettage (including bleeding, visceral damage, need for surgery, and mortality) were examined. and were compared. Results: There was no significant difference in fetal heart rate and intake of potassium chloride between the studied groups (p-value=0.361). The amount of hemoglobin drop in case and control group is 1.1±0.93 and 0.6±0.99, respectively, and no significant difference was found between the two groups (p-value=0.741). No visceral injury occurred in any of the two groups. Also, exploratory laparotomy, exploratory laparoscopy and hysterectomy were not required in any of the groups. There was one case requiring re-curtage in both groups. There was no maternal death in any of the groups.