Natural history of caesarean scar pregnancy

Abstract

The rate of cesarean sections (CS) around the world is increasing at an 'alarming' rate. In Poland the rate of CS is 43.85%. Increasing CS rates are associated with short-term and long-term maternal and perinatal consequences. Previous CS increases the risk of cesarean scar pregnancy (CSP), placenta previa, placenta accreta spectrum (PAS) disorders and a uterine rupture. According to the theory of professor Ilan Timor-Tritsch, placenta previa accreta in a woman after previous CS is a consequence of continuation of CSP that was not recognized or not treated in the first trimester.

Impact of selected risk factors on uterine healing after cesarean section in women with single-layer uterine closure: A prospective study using two- and three-dimensional transvaginal ultrasonography

“…Moreover, women with extremely low RMT face life-threatening complications in subsequent pregnancies due to the risk of scar rupture at 21 weeks of gestation. 26 Taking into consideration the above problems and the limited knowledge gynecologists have of niche-related complications, we suggest cesarean section scar assessment be routinely performed in all women who have undergone cesarean section at the end of puerperium.…”

Cesarean Scar Pregnancy: Current Understanding and Treatment Including Role of Minimally Invasive Surgical Techniques

“…Series describing expectant management of diagnosed CSPs all involve small case numbers and hysterectomy rates between 50% and 100%, usually associated with PASD. [ 17 18 19 ] In one series which prospectively followed women with a first-trimester scar-related pregnancy all had PASD diagnosed at the time of the repeat cesarean delivery. [ 3 ]…”

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

“…Caesarean scar pregnancy (CSP) is a type of ectopic pregnancy implanted into the defect in the myometrium at the hysterotomy site from a previous caesarean delivery [1]. Untreated CSP may be associated with life-threatening complications, such as placenta praevia or accreta, uterine rupture and haemorrhage [2,3]. Therefore, an early diagnosis is crucial to decrease maternal morbidity and mortality.…”