Clinical characteristics and treatment of different types of cesarean scar pregnancy

Abstract

Objectives: The purpose of this study was to evaluate the clinical characteristics and compare the treatment efficacy of different types of cesarean scar pregnancy (CSP). Material and methods: We performed a retrospective chart review of 66 women (69 cases) with CSP who received treatment with mifepristone/methotrexate (MTX) plus curettage, uterine artery embolization (UAE) plus curettage, additional MTX, or laparotomy, and compared the clinical characteristics, treatment efficacy, and occurrence of complications among 3 types of CSP (partial, complete, and mass type). Results: Review of the 69 cases revealed a considerable increase of gestational duration(p < 0.001), sac/lesion size(p < 0.001) and vaginal bleeding (p < 0.05) in patients with mass-type CSP compared to that of other types. All CSP cases were successfully treated, 4 cases of mass-type received laparotomy and none of the cases required a hysterectomy. Severe bleeding was observed in 2 cases of partial-type and complete-type, respectively, and 3 cases for mass-type. Moreover, bleeding occurred during initial treatment with mifepristone plus curettage in partial-type cases, but not with UAE plus curettage. Conclusions: UAE plus curettage is a more effective treatment option for partial-and complete-type of CSP than mifepristone plus curettage. The cases of mass-type often need surgery and are prone to have longer gestational duration, larger lesions, and more vaginal bleeding.

Uterine haematoma — a complication after delayed management of caesarean scar pregnancy

“…Therefore, an early diagnosis is crucial to decrease maternal morbidity and mortality. There is no universal treatment option for CSP and data about the complications of treatment are scarce [4,5]. Selective uterine artery chemoembolization with intra-arterial methotrexate (MTX) infusion followed by suction curettage is one of the treatment options for CSP and is considered as a safe method.…”

Cesarean scar pregnancy complicated by uterine wall sequestration

“…Cesarean scar pregnancy (CSP) is a potentially life-threatening, rare type of ectopic gestation [1][2][3]. In most of the cases, the uterus-sparing methods are the first-line treatment options for the management of CSP.…”