Cesarean scar pregnancy with expectant management

Abstract

Aim This study aimed to ascertain whether the lower anterior myometrial thickness (MT) between the bladder and the gestational sac in early pregnancy can be used to predict clinical outcomes in women with cesarean scar pregnancy (CSP) after expectant management. Methods We retrospectively analyzed the clinical data and early pregnancy ultrasound images of 21 patients who received expectant management for CSP. Among them, 11 patients with serious complications during pregnancy, such as intraoperative blood loss ≥1000 mL or with severe forms of morbidly adherent placenta (MAP; placenta increta or placenta percreta), were assigned to group A. The remaining 10 patients without serious complications during pregnancy were assigned to group B. The difference in MT between groups A and B was analyzed using nonparametric Mann–Whitney U test. Results There was a statistically significant difference in MT between the groups (U = 20.000, p = 0.013). The area under the receiver operating characteristics (ROC) curve was 0.818, and the optimal cut‐off value for MT was 3.3 mm. Conclusion Lower anterior MT around the gestational sac was correlated with severe complications, such as massive intraoperative bleeding or severe forms of MAP in patients with CSP.

An update and review of nontubal ectopic pregnancy management

“…In these women, 73% hemorrhaged with an estimated blood loss (EBL) ≥1000 ml, and 55% required blood products. Other case series have reported similar results [13,14].…”

Caesarean scar pregnancy presenting at 17 weeks with a journey involving an exploratory laparotomy, continuing pregnancy and delivery at 34 weeks: A case report

“…Myometrial thickness has been proven to be a prognostic marker [ 17 ]. A study by Fu et al (2022) showed that in the first-trimester scan, the optimal cut-off for myometrial thickness was 3.3 mm, being associated with severe forms of PAS in patients with CSP [ 18 ].…”

Hidden in plain sight: role of residual myometrial thickness to predict outcome of Cesarean scar pregnancy

“…The retrospective study of Fu et al 27 evaluated the performance of the RMT measured between the bladder and the gestational sac in early pregnancy in predicting clinical outcome in 21 patients who received expectant management for CSP. Patients were classified into two groups: those who experienced serious complications during pregnancy, such as intraoperative blood loss ≥ 1000 mL or placenta increta or percreta (n = 11), and those without serious complications during pregnancy (n = 10).…”

“…The retrospective study of Fu et al 27 . evaluated the performance of the RMT measured between the bladder and the gestational sac in early pregnancy in predicting clinical outcome in 21 patients who received expectant management for CSP.…”