Erratum Obstet Gynecol Sci 2016;59(5):426 http://dx.doi.org/10.5468/ogs.2016.59.5.426 pISSN 2287-8572 · eISSN 2287-8580
Figure Correction In the published article by Lee JH et al. entitled “Concomitant ultrasound-guided intra-gestational sac methotrexate-potassium chloride and systemic methotrexate injection in the recurrent cesarean scar pregnancy” (Obstet Gynecol Sci 2016;59(3):245-248. doi: http://dx.doi.org/10.5468/ogs.2016.59.3.245), the Figure 2 is given incorrectly. TheJu Hak Editorial would to and correct Figurein 2recurrent and CSP apologizes for any inconvenience that it Lee, et al.Office Concomitant intra-GSlike MTX-KCL systemicthe MTX injection may have caused. A
(mlU/mL)
30,000
(b) Systemic MTX injection
25,000
(c) Intra-gestational sac MTX injection
20,000 15,000
(d) Systemic MTX injection 10,000
(a) Intra-gestational sac KCL injection
5,000 0 Day 0
Day 5
Day 7
Day 8
Day 10 Day 12 Day 14 Day 16 Day 18 Day 19 Day 22 Day 26 Day 29 Day 36 Day 43 Day 70
B (mlU/mL)
(b) Systemic MTX injection
70,000 60,000 50,000 40,000 30,000 20,000
(a) Intra-gestational sac MTX-KCL injection with systemic MTX
10,000 0 Day 0
Day 3
Day 6
Day 13
Day 27
Day 48
Day 77
Day 108
Fig. 2. Changes in serum β-human chorionic gonadotropin concentrations. (A) Changes in serum β-human chorionic gonadotropin concentrations during followup at the first cesarean scar pregnancy. (a) Intra-gestational sac potassium chloride (KCL) injection, (b) systemic methotrexate (MTX) injection, (c) intra-gestational sac MTX injection, and (d) systemic MTX injection. (B) Changes in serum β-human chorionic gonadotropin concentrations during follow-up of a recurrent cesarean scar pregnancy. (a) Intra-gestational sac MTX-KCL injection with systemic MTX and (b) systemic MTX injection.
Ju Hak Lee, et al. Concomitant intra-GS MTX-KCL and systemic MTX injection in recurrent CSP But Hasegawa [4] suggested that surgical management The Figureet2al.should be corrected as follows.may be useful in recurrent cases of CSP for the subsequent
might be a preferable option for patients with first CSP, if the normal intrauterine pregnancy. We agree with their suggesA patients wish to become pregnant in the future. There are sev- tion that a laparotomy in the first event of CSP could result in (mlU/mL) eral case reports on surgical treatment at the first CSP, how- post-operative abdominal adhesion that can cause subfertility. 30,000 ever, not recurrent CSP. For example, in 2004, Maymon et al. A separate treatment of intra-GS MTX or systemic MTX (b) Systemic MTX injection 25,000 [7] reported emergency laparotomy and excision of the preg- might fail because of the poor vascularity and surrounding (c) Intra-gestational sac MTX 20,000 nancy site in the cesarean scar. In 2006, Lee et al.injection [8] reported fibrosis in the recurrent case [5]. In agreement, the intra-GS 15,000 the excision of CSP with laparoscopic surgery. In addition, Park MTX injection did not work at the first CSP in our case; there(d) Systemic MTX injection et10,000 al. [9] reported the treatment of CSP by transvaginal hyster- fore, we chose the concomitant intra-GS and systemic MTX otomy in 2008. (a) Intra-gestational sac KCL treatment at the recurrent CSP that was effective. McKenna et 5,000 In 2006, Ben Nagi etinjection al. [5] reported the third case of recur- al. [10] previously reported that was successfully treated Fig.a2.case Changes in serum choβ-human 0 rionic gonadotropin concentrations. (A) rent CSP. 3 8consecutive CSPs were DayInterestingly, 0 Day 5 Day 7 Day Day 10 Day 12 Day 14 Day 16 Daydiagnosed 18 Day 19 Day 22inDay 26with Day 29 simultaneous Day 36 Day 43 Day 70 intra-GS MTX without KCL and systemic Changesnot in serum β-human their case. The first treatment was laparoscopy and suction MTX at the first CSP, although recurrent CSP. chorionic gonadotropin concentrations during followB evacuation at 12 weeks of gestational age and, 10 months Based on our case, concomitant treatment of intra-GS MTX(mlU/mL) up at the first cesarean scar pregnancy. (a) (b) Systemic injection later, and MTX curettage at 7 KCL and systemic MTXIntra-gestational would be a minimally invasivechloride option 70,000the second treatment was suction sac potassium weeks with efficacy and safety. However, it had limitations such as 60,000 of gestational age without complication. Six months (KCL) injection, (b) systemic methotrexate (MTX) injection, intra-gestational later, long term follow-up period of 70 days at(c)the first CSP and 50,000the final treatment was surgical removal at 4 weeks of sacCSP MTXininjection, (d) systemic MTX gestational age without complications; and 3 months later, a 108 days at the recurrent our case,and respectively. 40,000 injection. (B) Changes in serum β-human laparotomy was performed to repair the uterine-scar defect. Future pregnancy and prevention of recurrence are the first 30,000 chorionic gonadotropin concentrations After the operation, the patient had 2 normal intrauterine priority to consider in the management of recurrent CSP. Fur20,000 during follow-up of a recurrent cesarean (a) Intra-gestational sac MTX-KCL injection with systemic MTX pregnancies. However, both pregnancies aborted spontanethermore, patient’s pain and cosmesis must also be considered scar pregnancy. (a) Intra-gestational sac 10,000 ously 0at 7 weeks and 8 weeks of gestational age, respectively. currently. In a 2002 review, Fylstra [11] suggested that upon MTX-KCL injection with systemic MTX 0 Day 3 Day 6 Day 13 Day 27 Day 48 Day 77 Day 108 and (b)should systemicbeMTX injection.as the first Ben Nagi etDayal. [5] indicated that laparotomy for uterine repair diagnosis of CSP, laparotomy considered But Hasegawa et al. [4] suggested that surgical management
www.ogscience.org 426 might be a preferable option for patients with first CSP, if the patients wish to become pregnant in the future. There are several case reports on surgical treatment at the first CSP, however, not recurrent CSP. For example, in 2004, Maymon et al. [7] reported emergency laparotomy and excision of the pregnancy site in the cesarean scar. In 2006, Lee et al. [8] reported the excision of CSP with laparoscopic surgery. In addition, Park
may be useful in recurrent cases of CSP for the subsequent 247 normal intrauterine pregnancy. We agree with their suggestion that a laparotomy in the first event of CSP could result in post-operative abdominal adhesion that can cause subfertility. A separate treatment of intra-GS MTX or systemic MTX might fail because of the poor vascularity and surrounding fibrosis in the recurrent case [5]. In agreement, the intra-GS MTX injection did not work at the first CSP in our case; there-
www.ogscience.org
Figure Correction In the published article by Lee JH et al. entitled “Concomitant ultrasound-guided intra-gestational sac methotrexate-potassium chloride and systemic methotrexate injection in the recurrent cesarean scar pregnancy” (Obstet Gynecol Sci 2016;59(3):245-248. doi: http://dx.doi.org/10.5468/ogs.2016.59.3.245), the Figure 2 is given incorrectly. TheJu Hak Editorial would to and correct Figurein 2recurrent and CSP apologizes for any inconvenience that it Lee, et al.Office Concomitant intra-GSlike MTX-KCL systemicthe MTX injection may have caused. A
(mlU/mL)
30,000
(b) Systemic MTX injection
25,000
(c) Intra-gestational sac MTX injection
20,000 15,000
(d) Systemic MTX injection 10,000
(a) Intra-gestational sac KCL injection
5,000 0 Day 0
Day 5
Day 7
Day 8
Day 10 Day 12 Day 14 Day 16 Day 18 Day 19 Day 22 Day 26 Day 29 Day 36 Day 43 Day 70
B (mlU/mL)
(b) Systemic MTX injection
70,000 60,000 50,000 40,000 30,000 20,000
(a) Intra-gestational sac MTX-KCL injection with systemic MTX
10,000 0 Day 0
Day 3
Day 6
Day 13
Day 27
Day 48
Day 77
Day 108
Fig. 2. Changes in serum β-human chorionic gonadotropin concentrations. (A) Changes in serum β-human chorionic gonadotropin concentrations during followup at the first cesarean scar pregnancy. (a) Intra-gestational sac potassium chloride (KCL) injection, (b) systemic methotrexate (MTX) injection, (c) intra-gestational sac MTX injection, and (d) systemic MTX injection. (B) Changes in serum β-human chorionic gonadotropin concentrations during follow-up of a recurrent cesarean scar pregnancy. (a) Intra-gestational sac MTX-KCL injection with systemic MTX and (b) systemic MTX injection.
Ju Hak Lee, et al. Concomitant intra-GS MTX-KCL and systemic MTX injection in recurrent CSP But Hasegawa [4] suggested that surgical management The Figureet2al.should be corrected as follows.may be useful in recurrent cases of CSP for the subsequent
might be a preferable option for patients with first CSP, if the normal intrauterine pregnancy. We agree with their suggesA patients wish to become pregnant in the future. There are sev- tion that a laparotomy in the first event of CSP could result in (mlU/mL) eral case reports on surgical treatment at the first CSP, how- post-operative abdominal adhesion that can cause subfertility. 30,000 ever, not recurrent CSP. For example, in 2004, Maymon et al. A separate treatment of intra-GS MTX or systemic MTX (b) Systemic MTX injection 25,000 [7] reported emergency laparotomy and excision of the preg- might fail because of the poor vascularity and surrounding (c) Intra-gestational sac MTX 20,000 nancy site in the cesarean scar. In 2006, Lee et al.injection [8] reported fibrosis in the recurrent case [5]. In agreement, the intra-GS 15,000 the excision of CSP with laparoscopic surgery. In addition, Park MTX injection did not work at the first CSP in our case; there(d) Systemic MTX injection et10,000 al. [9] reported the treatment of CSP by transvaginal hyster- fore, we chose the concomitant intra-GS and systemic MTX otomy in 2008. (a) Intra-gestational sac KCL treatment at the recurrent CSP that was effective. McKenna et 5,000 In 2006, Ben Nagi etinjection al. [5] reported the third case of recur- al. [10] previously reported that was successfully treated Fig.a2.case Changes in serum choβ-human 0 rionic gonadotropin concentrations. (A) rent CSP. 3 8consecutive CSPs were DayInterestingly, 0 Day 5 Day 7 Day Day 10 Day 12 Day 14 Day 16 Daydiagnosed 18 Day 19 Day 22inDay 26with Day 29 simultaneous Day 36 Day 43 Day 70 intra-GS MTX without KCL and systemic Changesnot in serum β-human their case. The first treatment was laparoscopy and suction MTX at the first CSP, although recurrent CSP. chorionic gonadotropin concentrations during followB evacuation at 12 weeks of gestational age and, 10 months Based on our case, concomitant treatment of intra-GS MTX(mlU/mL) up at the first cesarean scar pregnancy. (a) (b) Systemic injection later, and MTX curettage at 7 KCL and systemic MTXIntra-gestational would be a minimally invasivechloride option 70,000the second treatment was suction sac potassium weeks with efficacy and safety. However, it had limitations such as 60,000 of gestational age without complication. Six months (KCL) injection, (b) systemic methotrexate (MTX) injection, intra-gestational later, long term follow-up period of 70 days at(c)the first CSP and 50,000the final treatment was surgical removal at 4 weeks of sacCSP MTXininjection, (d) systemic MTX gestational age without complications; and 3 months later, a 108 days at the recurrent our case,and respectively. 40,000 injection. (B) Changes in serum β-human laparotomy was performed to repair the uterine-scar defect. Future pregnancy and prevention of recurrence are the first 30,000 chorionic gonadotropin concentrations After the operation, the patient had 2 normal intrauterine priority to consider in the management of recurrent CSP. Fur20,000 during follow-up of a recurrent cesarean (a) Intra-gestational sac MTX-KCL injection with systemic MTX pregnancies. However, both pregnancies aborted spontanethermore, patient’s pain and cosmesis must also be considered scar pregnancy. (a) Intra-gestational sac 10,000 ously 0at 7 weeks and 8 weeks of gestational age, respectively. currently. In a 2002 review, Fylstra [11] suggested that upon MTX-KCL injection with systemic MTX 0 Day 3 Day 6 Day 13 Day 27 Day 48 Day 77 Day 108 and (b)should systemicbeMTX injection.as the first Ben Nagi etDayal. [5] indicated that laparotomy for uterine repair diagnosis of CSP, laparotomy considered But Hasegawa et al. [4] suggested that surgical management
www.ogscience.org 426 might be a preferable option for patients with first CSP, if the patients wish to become pregnant in the future. There are several case reports on surgical treatment at the first CSP, however, not recurrent CSP. For example, in 2004, Maymon et al. [7] reported emergency laparotomy and excision of the pregnancy site in the cesarean scar. In 2006, Lee et al. [8] reported the excision of CSP with laparoscopic surgery. In addition, Park
may be useful in recurrent cases of CSP for the subsequent 247 normal intrauterine pregnancy. We agree with their suggestion that a laparotomy in the first event of CSP could result in post-operative abdominal adhesion that can cause subfertility. A separate treatment of intra-GS MTX or systemic MTX might fail because of the poor vascularity and surrounding fibrosis in the recurrent case [5]. In agreement, the intra-GS MTX injection did not work at the first CSP in our case; there-
www.ogscience.org
