A retrospective comparison of systemic and local methotrexate therapy applied before uterine curettage in caesarean scar pregnancy

This study aimed to evaluate the results of patients who were treated with different treatment modalities due to cesarean scar pregnancy in terms of treatment success, development of complications, and additional treatment need. Patients underwent dilatation-curettage (D/C) only group 1 (n=22), systemic methotrexate was applied on the first and fourth day and D/C was applied on the seventh day, group 2 (n=27) and those who received intracavitary methotrexate on the first day and D/C on the seventh-day group 3 (n=33) to be divided into three groups. The demographic information of the patients, length of stay, response to treatment, complication rates, and whether there was any difference in factors associated with the development of complications were compared between the groups. When the patients were evaluated, it was seen that those in group 2 had a lower gestational week (p=0.011). In addition, it was observed that the patients in group 2 had a significantly longer hospital stay (p0.05). In our study, we observed that the possibility of complication development among the three methods was less in patients who underwent intracavitary methotrexate, but we could not statistically determine that this situation was significant. We also found that the use of systemic methotrexate is the most disadvantageous method in terms of both the length of stay and the development of complications.

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