Diagnostic and Management Challenges of Caesarean Scar Ectopic Pregnancy in a Lower Middle Income Country

Asah‐Opoku, Kwaku; Oduro, Nana Essuman; Swarray‐Deen, Alim; Mumuni, Kareem; Koranteng, Isaac; Senker, R.; Rijken, Marcus J.; Nkyekyer, Kobinah

doi:10.1155/2019/4257696

Cited by 6 publications

(9 citation statements)

References 14 publications

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“…This risk of CSEP is not necessarily affected by the number of previous caesarean deliveries. [6][7][8] Women who have had an elective CS for breech presentation in a previous pregnancy are the ones mostly at risk due to poor formation of the lower uterine segment. 9,10 How and when CSP present?…”

Section: Discussionmentioning

confidence: 99%

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Caesarean scar ectopic pregnancy: a case report

Kailash¹,

Trivikrama²,

Shivakumar³

et al. 2022

Int J Reprod Contracept Obstet Gynecol

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Caesarean scar ectopic pregnancy (CSEP) is where the conceptus is implanted deep in the myometrium and at the exact scar site of the previous caesarean section. Symptoms include amenorrhea, pelvic pain and vaginal bleeding in the first trimester. The investigation of choice is transvaginal ultrasound. Individualized treatment options are based on gestational age, presence of embryonal cardiac activity, severity of symptoms, serum hCG levels and ultrasonography findings for CSEP. The combined use of laparoscopy and ultrasound guidance for the evacuation is helpful in deeply impacted CSEP. Because early diagnosis and treatment is important for the best outcome, every pregnant woman with a history of cesarean should be screened early in the first trimester of pregnancy.

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Section: Discussionmentioning

confidence: 99%

“…(5) cervical canal that is closed and empty; (6) observation of foetal pole and/or yolk sac with or without heart activity; (7) absence or deficiency of a healthy myometrium between the bladder and the gestational sac. 15 The last criterion allows differentiation of CSEP from a cervical-isthmic implantation.…”

Section: Criteria-csepmentioning

confidence: 99%

Caesarean scar ectopic pregnancy: a case report

Kailash¹,

Trivikrama²,

Shivakumar³

et al. 2022

Int J Reprod Contracept Obstet Gynecol

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“…Considering the present era with the rising number of CSs and the potential of CSP to have higher complication rates with increased size and vascularity, sonographers and gynecologists should be familiar with the diagnostic criteria of CSP through different training programs. 11 To date, there is no consensus regarding the optimal management of scar ectopic pregnancy. The aim is to remove the gestational sac before rupture as well as retain the future fertility with less chances of recurrence.…”

Section: Discussionmentioning

confidence: 99%

Cesarean Scar Pregnancy: Diagnostic and Management Dilemmas in Low-resource Settings

Singh¹,

Chaurasia²,

Sachan³

et al. 2022

Journal of South Asian Federation of Obstetrics and Gynaecology

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Background: Cesarean scar pregnancy (CSP) is a rare but catastrophic event. The incidence of cesarean section (CS) is on an increasing trend and hence is the incidence of CSP. Failure to diagnose and initiate prompt management of CSP may lead to uterine rupture, massive hemorrhage, and even maternal death. Methods: This study was conducted as a retrospective cohort study in women presenting to the Department of Obstetrics and Gynecology,

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“…There are various modalities for the management of CSP. These include expectant management, intramuscular or intralesional injection of methotrexate and surgical treatment [10]. Our patient was counselled in detail regarding all these options and was offered termination of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Cesarean Scar Pregnancy Resulting in Live Birth: A Case Report

Waheed¹,

Fatima²,

Salman³

et al. 2020

COS

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Caesarean Scar Pregnancy (CSP) is a rare form of ectopic pregnancy. The numbers of cesarean scar pregnancies have increased over the last few decades owing to increasing number of C section performed and also to increasing awareness and early ultrasound diagnosis. CSP have a high risk of uterine rupture and life-threatening hemorrhage, the pregnancy should be terminated once confirmed. There are very few cases in the literature reporting live birth as a result of such pregnancies. Here, we present a 34-years old, gravida 5 women with previous caesarian delivery. At six weeks, a transvaginal scan showed the presence of an ectopic pregnancy within the C section scar, despite this finding the pregnancy was continued to third trimester. This report suggests that successful pregnancy outcome is possible in some women with uterine cesarean scar pregnancy, but further analysis and more studies are required in order to describe the optimal protocol of expectant management of CSP.

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Diagnostic and Management Challenges of Caesarean Scar Ectopic Pregnancy in a Lower Middle Income Country

Cited by 6 publications

References 14 publications

Caesarean scar ectopic pregnancy: a case report

Caesarean scar ectopic pregnancy: a case report

Cesarean Scar Pregnancy: Diagnostic and Management Dilemmas in Low-resource Settings

Cesarean Scar Pregnancy Resulting in Live Birth: A Case Report

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