Evaluation of sonographic and color doppler findings before and after medical treatment in Cesarean Scar Pregnancy and its comparison with serum βhcG level

Abstract

Cesarean section is one of the rare clinical conditions that was first introduced in 1978. However, due to the increasing number of cesarean sections, the frequency of patients with CSP has also increased and the main goal of treating patients with CSP is Termination of pregnancy is to prevent heavy bleeding or rupture of the uterus during fetal curettage. The aim of this study was to evaluate the sonographic and color Doppler findings before and after medical treatment in ectopic pregnancies at the site of cesarean section and compare it with serum βhCG levels. Materials and Methods: Patients who referred to Al-Zahra Hospital in Tabriz with Cesarean Scar Pregnancy at the specified time interval and underwent ultrasound and primary Doppler of the RI closest myometrial artery to CSP were examined. Serum βhCG levels were also recorded. Patients with CSP who are candidates for drug therapy by systemic methotrexate injection or KCl injection into the sac were evaluated and the desired variables such as gestational age, CSP mass diameter, serum βhCG level, live fetus, RI of the closest myometrial artery to CSP were recorded. The results were compared at 72 hours, one week and two weeks later. Results: In this cross-sectional study, 30 patients with CSP diagnosis who were referred to Alzahra Hospital in Tabriz for drug treatment (systemic injection of methotrexate (MTX) (1 mg/kg) or KCL injection into the sac) were studied. The mean gestational age of the patients was 5.72±1.06 weeks and 3.58±1.70 days. At the beginning of the study, 6 cases (20.7%) were identified as live fetuses, none of which were alive after 72 hours. Serum βhcG levels decreased from the baseline to the end of the treatment. The diameter of the gestational sac increased up to 72 hours after the treatment and then decreased until the end of the treatment. Color Doppler RI values decreased after medical treatment until the end of treatment.