Caesarean section scar ectopic pregnancy: a new problem or new name for an old one?

Jurkovic, Davor

doi:10.1002/j.2205-0140.2009.tb00002.x

Cited by 10 publications

(6 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The placental growth of type 1 progresses into the cervico-isthmic space and then into endometrial cavity, whereas in type 2 the placenta attaches and develops directly within a cesarean scar niche, growing towards the inner surface of the uterine serosa [4]. If untreated, CSP exposes the patient to obstetric complications such as uterine rupture and hemorrhage during the first months of pregnancy or to the development of a placenta previa/accreta near term [5][6][7]. The mainstay management aimed at sparing fertility and reducing maternal morbidity, is an early diagnosis of CSP and its termination [2,8].…”

Section: Introductionmentioning

confidence: 99%

Hysteroscopic removal of cesarean scar pregnancy after primary therapy with methotrexate: a case series

Garuti¹,

Calabrese²,

Baudino³

et al. 2017

Clin. Exp. Obstet. Gynecol.

View full text Add to dashboard Cite

Purpose of Investigation:To present the clinical outcome of cesarean scar pregnancies (CSP) managed by methotrexate (MTX) administration followed by hysteroscopy removal. Materials and Methods: A retrospective study was undertaken in eight consecutive patients admitted to the present Hospital with a diagnosis of CSP, based on ultrasound assessment. The patients underwent systemic (five patients) or local (three patients) MTX administration for pregnancy termination, followed by hysteroscopy removal. A 27Fr resectoscope was used for hysteroscopy surgery. Results: Mean gestational age was of 7.8 weeks and five patients showed a viable embryo. All pregnancies were terminated after MTX; since drug administration, hysteroscopy removal was carried-out after a mean time of 36.1 days. Hysteroscopy view found type 1 and type 2 CSP in one and six patients, respectively. In one patient hysteroscopy assessment demonstrated a cervical pregnancy instead of a type 1 CSP suspected by ultrasound. Mean operating time was of 20.8 minutes, no further intervention was needed, and neither complications were reported. The mean time of menses resumption was of 35.5 days. After the first menstrual period all patients showed β-hCG level in the non-pregnant range and empty uterine cavities. Conclusions: Termination of CSP by MTX, combined with its hysteroscopic removal, resulted to be safe and effective.

show abstract

Section: Introductionmentioning

confidence: 99%

Hysteroscopic removal of cesarean scar pregnancy after primary therapy with methotrexate: a case series

Garuti¹,

Calabrese²,

Baudino³

et al. 2017

Clin. Exp. Obstet. Gynecol.

View full text Add to dashboard Cite

show abstract

“…11 The number of patients with cesarean scar pregnancy reported in the literature has since increased from 18 in 2002 to 161 in 2007. 12,13 Possible reasons for the increase are the rising rate of cesarean delivery and early diagnosis of cesarean scar pregnancy. Although the exact cause of cesarean scar pregnancy is still unknown, its occurrence may be linked to an existing scar defect or microscopic dehiscent tract generated between the cesarean scar and the endometrial canal.…”

Section: Discussionmentioning

confidence: 99%

“…17 Jurkovic et al performed D&C in 8 patients with cesarean scar pregnancy, but 3 patients had significant intraoperative hemorrhage. 13 Of these 3 patients, one was initially misdiagnosed as an incomplete miscarriage, and a blind D&C was performed. Seow et al reported a similar experience in 1 of 2 patients treated with D&C for cesarean scar pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Cesarean Scar Pregnancy With Suction Curettage: Our Experiences in Early Pregnancy

Karahasanoğlu

Uzun

Deregözü

et al. 2018

TOJ

View full text Add to dashboard Cite

Background: Cesarean scar pregnancy is an ectopic pregnancy embedded in the myometrium of a cesarean scar. Several types of conservative treatment have been used to treat cesarean scar pregnancy, but no management protocol has been established for this rare, life-threatening condition. The purpose of this study was to evaluate the feasibility of suction curettage as a first-line treatment in early cesarean scar pregnancy. Methods: During a 4-year period, 19 cases of cesarean scar pregnancy were diagnosed at Süleymaniye Maternity Hospital in Istanbul, Turkey. Suction curettage and Foley balloon tamponade were performed as a first-line treatment in 13 patients. Medical records and treatment results of the patients were evaluated. Results: The mean maternal age was 32.5 years (range, 24-39 years). The mean gestational sac diameter was 13.65 mm (range, 7.6-27 mm), and mean endometrial thickness was 10.7 mm (range, 6.7-14.6 mm). A measurable fetal pole for crown-rump length was available for 6 (46.1%) patients. None of the fetuses had cardiac activity. Suction curettage under ultrasound guidance and Foley balloon tamponade were successful as the primary treatment in 13 of 13 patients. No major complications occurred during or after the procedure. Conclusion: Our data suggest that surgical evacuation under ultrasound guidance with Foley balloon tamponade is a safe and successful treatment modality in carefully selected patients with early cesarean scar pregnancy.

show abstract

“…The number of reported cases of Cesarean scar pregnancy (CSP) has increased in the last 10 years because of the increase in Cesarean sections number and the improvement in ultrasound detection in the first trimester [3,[10][11][12][13][14]. Cervico-isthmic implantation is also viewed as a variation of EP [9,[15][16][17].…”

Section: Introductionmentioning

confidence: 99%

“…Some authors associate this localization with CSP as pregnancy located below the internal os [15,17]. Due to their relative rarity CSPs have proved difficult to study and there is still lack of agreement regarding the most appropriate diagnostic criteria and optimal strategies to treat this condition [9,10,12,[18][19][20]. Some specialists affiliate CSP, cervico-isthmic pregnancy (CIP) and cervical pregnancy into "pregnancy in an abnormal location" or "low-lying-implantation ectopic pregnancy" because the low segment is less capable of fibromuscular contraction to control bleeding [17,21].…”

Section: Introductionmentioning

confidence: 99%

Ectopic low-lying implantation pregnancy: analysis of outcomes depending on gestation age

Makukhina¹,

Makukhina²

2019

Russ Open Med J

View full text Add to dashboard Cite

The objective is to define the optimal term of treatment of ectopic low-lying implantation pregnancy (LIP), including cesarean scar pregnancies (CSP) and cervico-isthmic pregnancies (CIP). Material and Methods -A single-center retrospective study examining the data of 37 patients with CSP and CIP. Gestation age (GA), human chorionic gonadotropin (β-HCG) level, ultrasound protocols, outcomes and follow-up were evaluated. The patients were divided into two groups according to their gestation age (GA) calculated from the last menstrual period, i.e.: up to 55 days inclusively -1 st group, 56 days and more -2 nd group. Results -Significant difference was found in blood loss and repeated invasive procedures (RIP) numbers between the groups (р=0.010 and р=0.046, respectively). GA>55 days increases the risk of RIP for patients with LIP four times (OR=4.00, 95% CI 0.99-16.15). Conclusion -Termination of LIP performed in 1 -st trimester allows to preserve uterus in all cases. Blood loss and the risk of RIP were significantly lower if LIP termination was performed before 8 -th gestational week.

show abstract

Caesarean section scar ectopic pregnancy: a new problem or new name for an old one?

Cited by 10 publications

References 11 publications

Hysteroscopic removal of cesarean scar pregnancy after primary therapy with methotrexate: a case series

Hysteroscopic removal of cesarean scar pregnancy after primary therapy with methotrexate: a case series

Successful Treatment of Cesarean Scar Pregnancy With Suction Curettage: Our Experiences in Early Pregnancy

Ectopic low-lying implantation pregnancy: analysis of outcomes depending on gestation age

Contact Info

Product

Resources

About