Efficacy and safety of high-intensity focused ultrasound combined with suction curettage for the treatment of caesarean scar pregnancy: a systematic review and single-arm meta-analysis
Purpose Caesarean scar pregnancy (CSP) presents a significant clinical challenge owing to the associated risks of uterine scar rupture, severe haemorrhage and adverse maternal outcomes. This study aimed to assess the safety and efficacy of combining high-intensity focused ultrasound (HIFU) with suct...
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Taylor & Francis Group
2024-12-01
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| Series: | International Journal of Hyperthermia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/02656736.2024.2310019 |
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| author | Yu Jiang Yang Liu Nian Liu Shize Qin Shuting Zhong Xiaohua Huang |
| author_facet | Yu Jiang Yang Liu Nian Liu Shize Qin Shuting Zhong Xiaohua Huang |
| author_sort | Yu Jiang |
| collection | DOAJ |
| description | Purpose Caesarean scar pregnancy (CSP) presents a significant clinical challenge owing to the associated risks of uterine scar rupture, severe haemorrhage and adverse maternal outcomes. This study aimed to assess the safety and efficacy of combining high-intensity focused ultrasound (HIFU) with suction curettage for treating CSP.Methods We conducted a comprehensive search in four databases, namely PubMed, Web of Science, Embase and Cochrane Library, to identify published studies evaluating the use of HIFU combined with suction curettage to treat CSP. Intraoperative blood loss, treatment success rate, and reproductive results were the primary outcomes assessed.Results A total of 18 studies involving 1251 patients with CSP, all of whom received preoperative HIFU therapy were included. The average hospital stay was 6.22 days, the intraoperative blood loss was 26.29 ml and the incidence of adverse events was 15.60%, including abdominal or lower limb pain, fever, vaginal bleeding, haematuria and vomiting. Furthermore, post-treatment follow-up showed that serum β-human chorionic gonadotropin levels were rapidly normalized (average of 25.48 days) and menstruation returned (average of 33.03 days). The treatment had a remarkable success rate of 97.60% and a subsequent pregnancy rate of 68.70%.Conclusion While the combination of HIFU and suction-curettage may induce common adverse effects such as lower abdominal or limb pain, these reactions typically do not necessitate therapeutic intervention. Additionally, the size of the gestational sac is a determinant of the procedure’s success. In conclusion, HIFU combined with suction curettage demonstrates promising clinical efficacy, safety and favourable reproductive outcomes in managing CSP. |
| format | Article |
| id | doaj-art-3dcebafa39974a22b09773032a6bfda9 |
| institution | DOAJ |
| issn | 0265-6736 1464-5157 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
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| series | International Journal of Hyperthermia |
| spelling | doaj-art-3dcebafa39974a22b09773032a6bfda92025-08-20T02:58:11ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572024-12-0141110.1080/02656736.2024.2310019Efficacy and safety of high-intensity focused ultrasound combined with suction curettage for the treatment of caesarean scar pregnancy: a systematic review and single-arm meta-analysisYu Jiang0Yang Liu1Nian Liu2Shize Qin3Shuting Zhong4Xiaohua Huang5Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, ChinaDepartment of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, ChinaDepartment of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, ChinaDepartment of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, ChinaDepartment of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, ChinaDepartment of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, ChinaPurpose Caesarean scar pregnancy (CSP) presents a significant clinical challenge owing to the associated risks of uterine scar rupture, severe haemorrhage and adverse maternal outcomes. This study aimed to assess the safety and efficacy of combining high-intensity focused ultrasound (HIFU) with suction curettage for treating CSP.Methods We conducted a comprehensive search in four databases, namely PubMed, Web of Science, Embase and Cochrane Library, to identify published studies evaluating the use of HIFU combined with suction curettage to treat CSP. Intraoperative blood loss, treatment success rate, and reproductive results were the primary outcomes assessed.Results A total of 18 studies involving 1251 patients with CSP, all of whom received preoperative HIFU therapy were included. The average hospital stay was 6.22 days, the intraoperative blood loss was 26.29 ml and the incidence of adverse events was 15.60%, including abdominal or lower limb pain, fever, vaginal bleeding, haematuria and vomiting. Furthermore, post-treatment follow-up showed that serum β-human chorionic gonadotropin levels were rapidly normalized (average of 25.48 days) and menstruation returned (average of 33.03 days). The treatment had a remarkable success rate of 97.60% and a subsequent pregnancy rate of 68.70%.Conclusion While the combination of HIFU and suction-curettage may induce common adverse effects such as lower abdominal or limb pain, these reactions typically do not necessitate therapeutic intervention. Additionally, the size of the gestational sac is a determinant of the procedure’s success. In conclusion, HIFU combined with suction curettage demonstrates promising clinical efficacy, safety and favourable reproductive outcomes in managing CSP.https://www.tandfonline.com/doi/10.1080/02656736.2024.2310019Caesarean scar pregnancyhigh-intensity focused ultrasoundsuction curettageclinical efficacysafetyfavourable reproductive outcomes |
| spellingShingle | Yu Jiang Yang Liu Nian Liu Shize Qin Shuting Zhong Xiaohua Huang Efficacy and safety of high-intensity focused ultrasound combined with suction curettage for the treatment of caesarean scar pregnancy: a systematic review and single-arm meta-analysis International Journal of Hyperthermia Caesarean scar pregnancy high-intensity focused ultrasound suction curettage clinical efficacy safety favourable reproductive outcomes |
| title | Efficacy and safety of high-intensity focused ultrasound combined with suction curettage for the treatment of caesarean scar pregnancy: a systematic review and single-arm meta-analysis |
| title_full | Efficacy and safety of high-intensity focused ultrasound combined with suction curettage for the treatment of caesarean scar pregnancy: a systematic review and single-arm meta-analysis |
| title_fullStr | Efficacy and safety of high-intensity focused ultrasound combined with suction curettage for the treatment of caesarean scar pregnancy: a systematic review and single-arm meta-analysis |
| title_full_unstemmed | Efficacy and safety of high-intensity focused ultrasound combined with suction curettage for the treatment of caesarean scar pregnancy: a systematic review and single-arm meta-analysis |
| title_short | Efficacy and safety of high-intensity focused ultrasound combined with suction curettage for the treatment of caesarean scar pregnancy: a systematic review and single-arm meta-analysis |
| title_sort | efficacy and safety of high intensity focused ultrasound combined with suction curettage for the treatment of caesarean scar pregnancy a systematic review and single arm meta analysis |
| topic | Caesarean scar pregnancy high-intensity focused ultrasound suction curettage clinical efficacy safety favourable reproductive outcomes |
| url | https://www.tandfonline.com/doi/10.1080/02656736.2024.2310019 |
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