Value of crossover sign in anticipating under-8-week cesarean scar pregnancy treatment by foley insertion combined with suction curettage in vietnam

Abstract

Objectives: An earlier study completed at TuDu Hospital presented the efficacy of Foley insertion combined with fetal suction curettage at a high rate of success in treatment of cesarean scar pregnancy (CSP) of 8 weeks, but the efficacy of prognosticating factors for this approach has not been specifically addressed yet, especially crossover sign (COS) on ultrasound. We aimed to investigate the correlation between COS on ultrasound and the treatment results of CSP using Foley insertion combined with fetal suction. Materials and Methods: A case-control study of CSPs ≤ 8 weeks treated at TuDu Hospital during September 2017-April 2019 included 63 failures in the case group and 98 successes in the control group. Results: COS-2 + increased the likelihood of treatment success by 4.9 times (95% confidence interval: 1.8-13.5) compared with COS-1 cases. In addition, other factors favoring treatment success with statistical significance included no vascularization at cesarean scar on ultrasound (odds ratio [OR] = 7.1), gestational mass volume ≤4 cm3(OR = 3.7), and β-human chorionic gonadotropin at hospital admission ≤ 10,000 mIU/mL (OR = 6.1). Conclusion: COS imaging played an important role in the prediction of treatment outcomes for CSP 8 weeks by the combined approach of Foley insertion and fetal suction curettage.