The diagnosis, treatment, and follow-up of cesarean scar pregnancy

Timor‐Tritsch, I. E.; Monteagudo, Ana; Santos, R.; Tsymbal, Tanya; Pineda, G. Ullaguari; Arslan, Alan A.

doi:10.1016/j.ajog.2012.04.018

Cited by 372 publications

(374 citation statements)

References 92 publications

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“…The rates of IOL in women with previous CS are decreasing drastically worldwide, and the trend is shifting toward ERCS especially whenever any obstetrical indication necessitates termination of pregnancy [1,2]. In our study, we observed that mifepristone is associated with favorable outcome in 89 % of women (labor onset in 56 % and cervical ripening 33 %) within 48 h of administration of oral mifepristone.…”

Section: Discussionsupporting

confidence: 52%

“…Even though trial of labor after CS (TOLAC) is a reasonable option in majority of these women [4], still a significant proportion of these women undergo elective repeat CS (ERCS) due to limited options available for IOL in these women, thereby further compounding the dangerous trend of rising rates of CS [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, the number of pregnant women with previous CS is also increasing dramatically [1,2]. This is not only leading to a massive escalation in the cost of the obstetric services but also increasing the incidence of previously rare but catastrophic complications of pregnancy (e.g., cesarean scar pregnancy, morbid adherent placenta, uterine rupture, and feto-maternal morbidity) [2]. In addition, the increase in the number of pregnant women with previous CS is posing severe constraint on the already scarce resources in the developing countries [3].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Retrospective Case–Control Study Evaluating the Role of Mifepristone for Induction of Labor in Women with Previous Cesarean Section

Sharma

Soni

et al. 2015

J Obstet Gynecol India

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Objective To investigate the role of ''mifepristone'' for induction of labor (IOL) in pregnant women with prior cesarean section (CS).Methods In this retrospective study, all pregnant women with prior CS who received oral mifepristone (400 mg) for IOL (as per clear obstetric indications) [group 1] were compared with pregnant women with prior CS who had spontaneous onset of labor (SOL) [group 2], with respect to incidence of vaginal delivery, CS, duration of labor, and various maternal and fetal outcomes. Results During the study period, 72 women received mifepristone (group 1) for IOL and 346 had SOL (group 2). In group 1 after mifepristone administration, 40 (55.6 %) women had labor onset, and 24 (33.3 %) women had cervical ripening (Bishop Score C 8) within 48 h. There were no statistically significant differences with respect to duration of labor (p value: 0.681), mode of delivery (i.e., normal delivery or CS-p value: 0.076 or 0.120, respectively), or maternal (blood loss or scar dehiscence/rupture uterus), or fetal outcomes (NICU admission) compared to women with previous CS with SOL (group 2). However,

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Section: Discussionsupporting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Retrospective Case–Control Study Evaluating the Role of Mifepristone for Induction of Labor in Women with Previous Cesarean Section

Sharma

Soni

et al. 2015

J Obstet Gynecol India

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“…This can lead to life-threatening haemorrhage during pregnancy or curettage, uterine rupture, disseminated intravascular coagulation and even a death. Sometimes, undiagnosed scar ectopic pregnancy can present with heavy bleeding, haemoperitoneum and shock after termination of early pregnancy or missed abortion [8]. Hence, early and accurate diagnosis is important for effective treatment to prevent these catastrophic complications.…”

Section: Presentation and Diagnosismentioning

confidence: 99%

Scar Ectopic Pregnancy

Patel

2015

J Obstet Gynecol India

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Scar ectopic pregnancy is the rarest form of ectopic pregnancy and has been increasingly diagnosed all over the world. This is a life-threatening form of abnormal implantation of embryo within the myometrium and fibrous tissues in a previous scar on the uterus, especially following caesarean section. With the increasing rate of caesarean section, there is a substantial increase in this condition with better understanding of this disease. The early and accurate diagnosis with timely management can prevent pregnancy complications such as haemorrhage, uterine rupture and can preserve fertility.

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“…Early identification of abnormal placentation allows for close follow-up, arrangement for transfer to tertiary care center, and early multidisciplinary planning and has been shown to lead to improved outcomes [4,5]. With increasing utilization of first trimester screening ultrasonography, detection of abnormal placentation early in pregnancy has increased.…”

Section: Discussionmentioning

confidence: 99%

Placenta Percreta with Occult Uterine Rupture in the First Trimester

Singh¹,

Jodicke²,

Reynolds³

et al. 2016

JCR

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Abstract:Placenta percreta is a rare finding in the first trimester and is often associated with severe maternal morbidity. Herein we describe a case of placenta percreta with occult uterine rupture in the first trimester in a patient with a history of two previous cesarean deliveries. Imaging was concerning for placenta accreta. Following onset of acute abdominal pain, she underwent exploratory laparoscopy, which was negative for overt uterine scar dehiscence. She ultimately underwent total abdominal hysterectomy at 14 weeks following severe bleeding, with intraoperative and histologic findings consistent with placenta percreta with dehiscence of the anterior lower uterine segment below the level of, and obscured by the vesicouterine peritoneum.Bleeding and severe abdominal pain in the first trimester in the context of prior uterine instrumentation should always prompt evaluation of the scar, by imaging in a stable patient, and by direct visualization if necessitated. However, maintenance of clinical suspicion for uterine scar dehiscence is warranted in patients at high risk even in the absence of direct visualization intra-operatively.

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The diagnosis, treatment, and follow-up of cesarean scar pregnancy

Cited by 372 publications

References 92 publications

A Retrospective Case–Control Study Evaluating the Role of Mifepristone for Induction of Labor in Women with Previous Cesarean Section

A Retrospective Case–Control Study Evaluating the Role of Mifepristone for Induction of Labor in Women with Previous Cesarean Section

Scar Ectopic Pregnancy

Placenta Percreta with Occult Uterine Rupture in the First Trimester

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