Cesarean Scar Ectopic Pregnancy: The Lurking Danger in Post Cesarean Failed Medical Abortion

Anant, Monika; Paswan, Anita; Jyoti, Chandra

doi:10.18502/jfrh.v13i4.2651

Cited by 5 publications

(6 citation statements)

References 17 publications

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“…CSPs pose significant risk of uterine rupture or dehiscence (a breakdown of the abdominal wall muscles which exposes internal organs to the environment) 6. With an incidence of 1 in 2000 normal pregnancies, these risks are not rare, and are increasing in frequency along with the popularity of caesarean deliveries 7. In addition to posing risk to the well-being of pregnant patients, as many as 60% of cases culminate in hysterectomy, rendering the patient sterile 8.…”

Section: Risks To Patients From Maternal Health Exemptionsmentioning

confidence: 99%

Abortion restrictions: the case for conscientious non-compliance on the part of providers

Randall,

Mago

2023

J Med Ethics

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This paper offers a qualified defence of physician non-compliance with antiabortion legislation in the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization. The paper examines two ethically troubling trends of post-Dobbs legislation: narrow and vague maternal health exemption clauses and mandatory reporting of miscarriages in jurisdictions where patients may criminal prosecution for medically induced abortions. It then examines and defends a professional obligation on the part of physicians to comply with the law. This obligation, however, is defeasible. The paper then argues that physicians’ obligations to comply with the law is defeated when the law is illegitimate and following the law would constitute bad medical practice. Finally, it argues that the ethically troubling trends in post-Dobbs antiabortion legislation may meet these criteria.

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Section: Risks To Patients From Maternal Health Exemptionsmentioning

confidence: 99%

Abortion restrictions: the case for conscientious non-compliance on the part of providers

Randall,

Mago

2023

J Med Ethics

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“…Some are estimated to be 1 in 100 pregnancies [5]; others are estimated at 20.70 per 1000 [6]. However, scar ectopic pregnancy is still considered a significant medical condition due to its potential for serious complications [7]. The risk factors for scar ectopic pregnancy include a history of previous cesarean sections or other uterine surgeries, such as myomectomy or cornual resection [8].…”

Section: Introductionmentioning

confidence: 99%

Scar Ectopic Pregnancy as an Uncommon Site of Ectopic Pregnancy: A Case Report and Literature Review

Elawad,

Alyousef,

Alkhaldi

et al. 2023

Life

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A cesarean scar pregnancy is a rare type of ectopic pregnancy that occurs when a fertilized egg implants in the scar from a previous cesarean section. It is a serious condition that can lead to significant morbidity and mortality if not managed promptly and appropriately. In this literature review and case report, we discuss the etiology, diagnosis, and management of cesarean scar pregnancy. We conducted a comprehensive search of relevant literature using electronic databases and included studies that reported on the diagnosis and management of cesarean scar pregnancy. We also present a case report of a patient with cesarean scar pregnancy who was managed surgically. The diagnosis of cesarean scar pregnancy is primarily done via transvaginal or transabdominal ultrasound, and medical or surgical management can be used depending on the gestational age, hemodynamic status, and patient preferences. The surgical approach, which involves hysteroscopy, laparoscopy, or laparotomy, is usually preferred, since it is associated with fast recovery and lower recurrence rates. However, it is crucial to consider the patient’s plans for future fertility when selecting the management approach. In conclusion, cesarean scar pregnancy is a rare but potentially life-threatening condition that requires prompt and appropriate management. Early diagnosis and treatment can prevent significant morbidity and mortality, and surgical management is usually preferred due to its higher success rates and lower recurrence rates.

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“…[ 10 , 11 ] Therefore, early diagnosis and effective treatment are key for reducing these risks in women with CSP. [ 12 ]…”

Section: Introductionmentioning

confidence: 99%

“…[10,11] Therefore, early diagnosis and effective treatment are key for reducing these risks in women with CSP. [12] The common symptom for CSP patients is usually little vaginal bleeding, occasionally accompanied by mild abdominal pain but most women are asymptomatic. So, diagnosis is mainly based on imaging examinations, namely, ultrasonography (US) and magnetic resonance imaging (MRI).…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic performance of magnetic resonance imaging and ultrasonography on the detection of cesarean scar pregnancy

et al. 2021

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Background : There is still a debate on which imaging method is the best to diagnose cesarean scar pregnancy (CSP). Accordingly, this study aimed to analyze the diagnostic performance of magnetic resonance imaging (MRI) and ultrasonography (US) on the detection of CSP based on current evidence in the literature. Methods: PubMed, Embase, Cochrane, Chinese Biomedical Documentation Service System, WanFang, and China National Knowledge Infrastructure databases were searched up to June 2020. The included studies were all comparisons of MRI and US in the diagnosis of CSP that adopted postoperative histological examination as the reference standard. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and area under the summary receiver operating characteristic curve (AUC) were calculated for MRI and US. Results: Thirteen studies were included, with a total sample size of 948 patients. The pooled sensitivity, specificity, PLR, NLR, and AUC of MRI in diagnosing CSP were 0.93 (95% CI, 0.91-0.95), 0.83 (95% CI, 0.75-0.89), 5.46 (95% CI, 3.70-8.05), 0.08 (95% CI, 0.06-0.11), and 0.96 (95% CI, 0.93-0.97), respectively; for US they were 0.84 (95% CI, 0.79-0.88), 0.73 (95% CI, 0.62-0.81), 3.06 (95% CI, 2.22-4.21), 0.23 (95% CI, 0.18-0.28), and 0.86 (95% CI, 0.83-0.89), respectively. Conclusion: We found that both MRI and US effectively diagnosed CSP; however, MRI had a higher diagnostic performance in detecting CSP than US.

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Cesarean Scar Ectopic Pregnancy: The Lurking Danger in Post Cesarean Failed Medical Abortion

Cited by 5 publications

References 17 publications

Abortion restrictions: the case for conscientious non-compliance on the part of providers

Abortion restrictions: the case for conscientious non-compliance on the part of providers

Scar Ectopic Pregnancy as an Uncommon Site of Ectopic Pregnancy: A Case Report and Literature Review

Diagnostic performance of magnetic resonance imaging and ultrasonography on the detection of cesarean scar pregnancy

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