Methotrexate for CSPs.

Cesarean scar pregnancy; Intragestational; Local; Methotrexate; Systemic; Treatment; Abortifacient Agents, Nonsteroidal; Pregnancy; Female; Humans; Methotrexate/therapeutic use; Cesarean Section; Cicatrix/etiology; Cicatrix/complications; Abortifacient Agents, Nonsteroidal/therapeutic use; Pregnancy, Ectopic/drug therapy; Cicatrix; Pregnancy, Ectopic; Obstetrics and Gynecology; General Medicine

Abstract :

[en] Expectant management of a cesarean scar pregnancy (CSP) is associated with a high risk of severe maternal morbidity. Therefore, most experts recommend immediate termination after the diagnosis of a CSP. However, there is no consensus about the optimal management of a CSP in terms of efficacy, safety, and preservation of future fertility. Methotrexate (MTX) is a folic acid antagonist that has been largely used to treat tubal ectopic pregnancies. This review summarizes the current knowledge and uncertainties about the administration of MTX as a medical or non-invasive option to terminate a CSP; the preferred injection route (systemic or local/intragestational), the comparison with other treatment modalities, and the prognostic factors for MTX success will be discussed, as well as the recommendations from scientific societies.

Disciplines :

Reproductive medicine (gynecology, andrology, obstetrics)

Author, co-author :

NOEL, Laure ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR)

Chantraine, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR)

Language :

English

Title :

Methotrexate for CSPs.

Publication date :

July 2023

Journal title :

Best Practice and Research. Clinical Obstetrics and Gynaecology

ISSN :

1521-6934

eISSN :

1532-1932

Publisher :

Bailliere Tindall Ltd, Netherlands

Volume :

Pages :

102364

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://api.elsevier.com/content/article/PII:S1521693423000718?httpAccept=text/xml

Available on ORBi :

since 25 January 2024

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