CSP: Removal of double-balloon cervical catheter

A double-balloon cervical catheter (ie, double-balloon Cook catheter) may be used for treatment of a CSP ≥6 0/7 and ≤8 6/7 weeks of gestation.

CSP: cesarean scar pregnancy; UAE: uterine artery embolization; MTX: methotrexate; hCG: human chorionic gonadotropin.

* The amount of fluid used to fill the balloons varies, and saline is progressively added until the gestational sac collapses. In general, the upper (anchor) balloon is inflated with 15 to 25 mL of saline and the lower (pressure) balloon is inflated with 10 to 15 mL of saline.

¶ Adjuvant therapies (eg, intragestational MTX or potassium chloride, systemic MTX) may also be used to induce fetal demise; however, these agents are rarely required.

Δ Double-balloon catheters (with or without adjuvant therapy) are effective at stopping embryonic/fetal cardiac activity at early gestational ages (ie, ≤8 6/7 weeks). In the rare event that these treatments do not cause cessation of cardiac activity, other treatments (eg, surgery, UAE) are needed.

Inset reproduced with permission from: Timor-Tritsch IE, Monteagudo A, Kaelin Agten A. Cesarean scar pregnancy: diagnosis and management. In: Operative Techniques in Obstetric Surgery, 1st ed, Belfort MA, Shamshirsaz AA, Clark SL, Fox KA (Eds), Lippincott Williams & Wilkins 2022. Copyright © 2022 Wolters Kluwer Health, Inc.

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CSP: Removal of double-balloon cervical catheter