{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:18:01Z","timestamp":1762867081024,"version":"3.37.3"},"reference-count":11,"publisher":"Wiley","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Obstetrics and Gynecology International"],"published-print":{"date-parts":[[2017]]},"abstract":"<jats:p><jats:italic>Background<\/jats:italic>. Caesarean scar pregnancy (CSP) is a rare ectopic pregnancy associated with life-threatening complications. To date, no therapeutic protocols have been established. Sono-guided local methotrexate (MTX) injection is a relatively easy and low-invasive treatment. Additional systemic MTX is sometimes needed for CSP cases, especially when <jats:italic>\u03b2<\/jats:italic>-subunit human chorionic gonadotropin (<jats:italic>\u03b2<\/jats:italic>-hCG) levels are &gt;20,000\u2009mIU\/ml at diagnosis. We report on six cases of CSP treated with local MTX injection, five of which received combined local treatment.<jats:italic> Methods<\/jats:italic>. Under intravenous anesthesia, six CSPs including a case with <jats:italic>\u03b2<\/jats:italic>-hCG levels &gt;20,000\u2009mIU\/ml received MTX injection to the gestational sac. Five cases received gestational sac aspiration. Three cases had additional local potassium chloride injection and one case had a saline injection aiming at the fetal heart beat concurrent with MTX injection. MTX was administered weekly if <jats:italic>\u03b2<\/jats:italic>-hCG levels stayed beyond the expected values.<jats:italic> Outcomes<\/jats:italic>. All cases achieved <jats:italic>\u03b2<\/jats:italic>-hCG normalization without additional systemic MTX, with one case having a successful pregnancy after treatment.<jats:italic> Conclusion<\/jats:italic>. Sono-guided local MTX injection with concurrent local treatment might be a potentially effective approach for CSP cases. The accumulation of further cases is necessary to confirm this.<\/jats:p>","DOI":"10.1155\/2017\/9543570","type":"journal-article","created":{"date-parts":[[2017,3,15]],"date-time":"2017-03-15T17:08:35Z","timestamp":1489597715000},"page":"1-5","source":"Crossref","is-referenced-by-count":3,"title":["Successful Treatment of Caesarean Scar Pregnancies by Local Treatment Only"],"prefix":"10.1155","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6914-5054","authenticated-orcid":true,"given":"Shinji","family":"Tanigaki","sequence":"first","affiliation":[{"name":"Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chie","family":"Nagata","sequence":"additional","affiliation":[{"name":"Department of Education for Clinical Research, National Center for Child Health and Development, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazunori","family":"Ueno","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kawasaki Municipal Hospital, Kawasaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuaki","family":"Ozawa","sequence":"additional","affiliation":[{"name":"Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinichi","family":"Nagaoka","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kyorin University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kei","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kyorin University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruhiko","family":"Sago","sequence":"additional","affiliation":[{"name":"Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsutoshi","family":"Iwashita","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kyorin University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aog.0000218690.24494.ce"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.974"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2015.12.130"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.07.1780"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-013-2765-4"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.125998"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.03.007"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(97)81930-9"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1111\/jog.12414"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.09.012"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh060"}],"container-title":["Obstetrics and Gynecology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/ogi\/2017\/9543570.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/ogi\/2017\/9543570.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/ogi\/2017\/9543570.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,3,15]],"date-time":"2017-03-15T17:08:35Z","timestamp":1489597715000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/ogi\/2017\/9543570\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017]]},"references-count":11,"alternative-id":["9543570","9543570"],"URL":"https:\/\/doi.org\/10.1155\/2017\/9543570","relation":{},"ISSN":["1687-9589","1687-9597"],"issn-type":[{"type":"print","value":"1687-9589"},{"type":"electronic","value":"1687-9597"}],"subject":[],"published":{"date-parts":[[2017]]}}}