Expectant management of cesarean scar pregnancy in 13 patients

Yang, Xinrui; Zheng, Weiran; Zhang, Huijing; Wei, Xiaoyu; Yan, Jie; Yang, Huixia

doi:10.1080/14767058.2021.1940942

Cited by 7 publications

(6 citation statements)

References 17 publications

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“…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].…”

Section: Expectant Managementsupporting

confidence: 66%

An update and review of nontubal ectopic pregnancy management

Kostroun

Robinson

2023

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of review Nontubal ectopic pregnancies appear to be increasing in prevalence. Increasingly, minimally invasive methods for management are being utilized. A current literature review and recommendations for management of nontubal ectopic pregnancy is presented in this review. Recent findings Nontubal ectopic pregnancies are less common than tubal ectopic pregnancies but present a unique and significant threat to patient's health and are optimally managed by specialists familiar with the condition. Early diagnosis, prompt treatment and close follow-up to resolution are critical. Recent publications focus on fertility-sparing and conservative management through the use of medications both systemic and local; as well as minimally invasive surgical techniques. The Society of Maternal Fetal Medicine recommends against expectant management of cesarean scar pregnancies; however, optimal treatment is unknown and this holds true for management of other nontubal ectopic pregnancies. Summary Minimally invasive and fertility sparing management should be the mainstay in treatment of stable patients with nontubal ectopic pregnancy.

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“…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].…”

Section: Expectant Managementsupporting

confidence: 66%

An update and review of nontubal ectopic pregnancy management

Kostroun

Robinson

2023

Current Opinion in Obstetrics &Amp; Gynecology

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“…Conversely, Yang et al observed that individuals with type II b and type III b CSP typically opt for immediate termination of their pregnancies during early gestation rather than pursuing expectant management. 17 Nonetheless, some doctors have indicated hysteroscopic treatment as the optimal choice for treating CSP, 18 while others hold divergent perspectives on this matter. Excision of the CSP and subsequent repair of the scar may constitute a more favorable management approach, offering potential benefits for future fertility.…”

Section: Discussionmentioning

confidence: 99%

Clinical Application of a New Cesarean Scar Pregnancy Classification and Evaluation System and a Risk Scoring System

Fu,

Zhang,

Zhou

et al. 2024

IJGM

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Cesarean scar pregnancy (CSP) is an uncommon form of ectopic pregnancy that carries the risk of severe bleeding. To date, there has not been a universally accepted classification and treatment strategy. We performed this study to establish a risk scoring system and new CSP classification system for CSP and evaluate its efficacy. Methods: A total of five groups were generated based on different methods of treatment, and the factors that increase the risk of intraoperative bleeding were examined in our center from 2013 to 2018. The construction of a risk scoring system in this study was based on the use of the chi-square test and multivariate logistic regression analysis. To determine the appropriate cutoff scores, receiver operating characteristic (ROC) curves and the area under the curve (AUC) were generated. Results: We identified the main high-risk factors for excessive intraoperative hemorrhage during CSP surgery through univariate and multivariate analyses. Within this investigation, the risk factors included gestational sac location and gestational sac diameter. Through analysis, an optimal cutoff score of 3 was determined, and the area under the ROC curve was calculated to be 0.8113 (95% CI=0.7696-0.8531). A score ranging from 0-3 was classified as low risk, while a score ranging from 5-7 was classified as high risk. Additionally, a new classification system for CSP has been established based on sonographic parameters. We also established a diagnostic and treatment process for CSP patients according to the risk scoring method and new CSP classification. Conclusion:We identified the high-risk factors associated with bleeding during CSP surgery and developed a scoring system incorporating these factors. The utilization of this novel CSP typing method, in conjunction with the risk scoring system, can effectively inform doctors in their decision-making process concerning treatment strategies for patients with CSP.

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“…It has been suggested that cesarean scar pregnancy represents a precursor of PAS disorders 13–16 . Cesarean scar pregnancy markedly increases the risk of abnormal invasive placentation and leads to severe maternal morbidity with placenta accrete spectrum disorders, massive bleeding, and emergency hysterectomy.…”

Section: First Trimester and Midtrimester Screening For Pas Disordersmentioning

confidence: 99%

“…It has been suggested that cesarean scar pregnancy represents a precursor of PAS disorders. [13][14][15][16] Cesarean scar pregnancy markedly increases the risk of abnormal invasive placentation and leads to severe maternal morbidity with placenta accrete spectrum disorders, massive bleeding, and emergency hysterectomy. Given the risk of life-threatening complications, termination of pregnancy is generally recommended in cases of cesarean scar pregnancy.…”

Section: Introductionmentioning

confidence: 99%