Treatment of Early Cesarean Scar Pregnancy with Double Balloon Catheter: A Systematic Review of the Literature
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...
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| Format: | Article |
| Language: | English |
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IMR Press
2023-10-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/50/10/10.31083/j.ceog5010222 |
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| author | Irene Passerini Francesco Marasciulo Federico Prefumo Anna Fichera Nicola Fratelli Filippo Alberto Ferrari Federico Ferrari Franco Odicino |
| author_facet | Irene Passerini Francesco Marasciulo Federico Prefumo Anna Fichera Nicola Fratelli Filippo Alberto Ferrari Federico Ferrari Franco Odicino |
| author_sort | Irene Passerini |
| collection | DOAJ |
| description | 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). |
| format | Article |
| id | doaj-art-681eae5c3cf74eb985c770a232cb8eb4 |
| institution | DOAJ |
| issn | 0390-6663 |
| language | English |
| publishDate | 2023-10-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-681eae5c3cf74eb985c770a232cb8eb42025-08-20T03:18:19ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-10-01501022210.31083/j.ceog5010222S0390-6663(23)02176-0Treatment of Early Cesarean Scar Pregnancy with Double Balloon Catheter: A Systematic Review of the LiteratureIrene Passerini0Francesco Marasciulo1Federico Prefumo2Anna Fichera3Nicola Fratelli4Filippo Alberto Ferrari5Federico Ferrari6Franco Odicino7Department of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, ItalyDepartment of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, ItalyObstetrics Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, ItalyDepartment of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, ItalyDepartment of Obstetrics and Gynecology, Spedali Civili di Brescia, 25123 Brescia, ItalyDepartment of Obstetrics and Gynecology, AOUI-University of Verona, 37129 Verona, ItalyDepartment of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, ItalyDepartment of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, ItalyBackground: 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).https://www.imrpress.com/journal/CEOG/50/10/10.31083/j.ceog5010222cesarean scar pregnancydouble-balloon catheterfoley |
| spellingShingle | Irene Passerini Francesco Marasciulo Federico Prefumo Anna Fichera Nicola Fratelli Filippo Alberto Ferrari Federico Ferrari Franco Odicino Treatment of Early Cesarean Scar Pregnancy with Double Balloon Catheter: A Systematic Review of the Literature Clinical and Experimental Obstetrics & Gynecology cesarean scar pregnancy double-balloon catheter foley |
| title | Treatment of Early Cesarean Scar Pregnancy with Double Balloon Catheter: A Systematic Review of the Literature |
| title_full | Treatment of Early Cesarean Scar Pregnancy with Double Balloon Catheter: A Systematic Review of the Literature |
| title_fullStr | Treatment of Early Cesarean Scar Pregnancy with Double Balloon Catheter: A Systematic Review of the Literature |
| title_full_unstemmed | Treatment of Early Cesarean Scar Pregnancy with Double Balloon Catheter: A Systematic Review of the Literature |
| title_short | Treatment of Early Cesarean Scar Pregnancy with Double Balloon Catheter: A Systematic Review of the Literature |
| title_sort | treatment of early cesarean scar pregnancy with double balloon catheter a systematic review of the literature |
| topic | cesarean scar pregnancy double-balloon catheter foley |
| url | https://www.imrpress.com/journal/CEOG/50/10/10.31083/j.ceog5010222 |
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