Outcome of cesarean scar pregnancy treated with local methotrexate injection

Le Minh Tam, Tomomi Kotani, Tran Manh Linh, Phan Thi Minh Thu, Tran Viet Khanh, Nguyen Thi Kim Anh, Nguyen Tran Thao Nguyen, Yoshinori Moriyama, Eiko Yamamoto, Nguyen Vu Quoc Huy, Truong Quang Vinh, Cao Ngoc Thanh, Fumitaka Kikkawa

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Local injection of methotrexate (MTX) has been widely used for caesarean scar pregnancy (CSP), but the optimal candidate remains undetermined. The aim of this study is to determine the risk factors associated with treatment failure among patients who received a single dose of local MTX. This is a retrospective cohort study. Clinical information was compared between treatment success vs. failure groups. Risk factors related to treatment failure were also investigated with multivariate analysis. Of 47 patients diagnosed with CSP, 30 received local MTX injection. The initial serum ss-human chorionic gonadotropin (hCG) level in the failure group was significantly higher than in the success group (p = 0.048), and the cut-off value was 47,000 mIU/ml. The rate of type 2 position of the gestational sac in the failure group was significantly higher than in the treatment success group (p = 0.031). A high initial serum ss-hCG level (≥ 47,000 mIU/ml) was identified as the independent risk factor for treatment failure (adjusted odds ratio = 21.9; 95% confidence interval = 1.3-383.1). Type 2 gestational sac position and a higher level of ss-hCG at diagnosis appear to be associated with poor outcomes after local injection of a single dose of MTX.

Original languageEnglish
Pages (from-to)15-23
Number of pages9
JournalNagoya journal of medical science
Issue number1
Publication statusPublished - 01-02-2020
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Medicine(all)


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