Expectant management of a caesarean scar pregnancy

Abraham, Reena; Weston, Michael

doi:10.3109/01443615.2012.703263

Cited by 12 publications

(5 citation statements)

References 7 publications

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“…3 Therefore, only 34 cases of true CSP with a positive fetal heartbeat have been reported after 14 weeks. [3][4][5][6][7][8][9][10][11][12] In most of cases, these patients wanted to continue the pregnancy despite awareness of major risks. Hysterectomy was necessary in 64.7%, and uterine rupture occurred in 26.5% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Most CSP are diagnosed and terminated in the first trimester because of the risk of early hemorrhage or to prevent the high risk of massive bleeding or hysterectomy . Therefore, only 34 cases of true CSP with a positive fetal heartbeat have been reported after 14 weeks . In most of cases, these patients wanted to continue the pregnancy despite awareness of major risks.…”

Section: Discussionmentioning

confidence: 99%

“…Most of them are now diagnosed in the first trimester and are terminated early because of the high risk of uterine rupture, morbidly adherent placenta, massive hemorrhage and hysterectomy . After 14 weeks, only a few cases are known, and most of deliveries end in massive bleeding and hysterectomy . We report a rare case of termination of a CSP in the second trimester with a posterior hysterotomy and conservative management of the placenta.…”

Section: Introductionmentioning

confidence: 97%

“…3 After 14 weeks, only a few cases are known, and most of deliveries end in massive bleeding and hysterectomy. [3][4][5][6][7][8][9][10][11][12] We report a rare case of termination of a CSP in the second trimester with a posterior hysterotomy and conservative management of the placenta. This first-time approach allowed a successful uterus-sparing treatment without massive bleeding.…”

Section: Introductionmentioning

confidence: 99%

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Cesarean scar pregnancy with deep serosal invasion at 16 weeks: Uterus‐sparing surgery with posterior hysterotomy after transcatheter arterial embolization

Sroussi

Panchbhaya

Boujlel

et al. 2018

J of Obstet and Gynaecol

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We report a case of cesarean scar pregnancy at 16 weeks. Magnetic resonance imaging confirmed the isthmic ectopic location with an empty fundus and a high suspicion of placental invasion to the anterior myometrium. Because of pelvic pain, bleeding and the major risks of hysterectomy, a decision was made to terminate the pregnancy. After a preventive pelvic artery embolization, we performed an unusual posterior isthmic hysterotomy for the extraction of the fetus, followed by conservative management of the placenta. Bleeding loss was 300 mL, and no complication was reported. Successive magnetic resonance imaging was planned and 6 months later, there were no placental remnants. At 7 months, an office hysteroscopy revealed a normal uterine cavity. In case of cesarean scar pregnancy in the second trimester with an emergency need to interrupt pregnancy, posterior hysterotomy with conservative treatment of placenta may be an option to avoid massive bleeding and hysterectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cesarean scar pregnancy with deep serosal invasion at 16 weeks: Uterus‐sparing surgery with posterior hysterotomy after transcatheter arterial embolization

Sroussi

Panchbhaya

Boujlel

et al. 2018

J of Obstet and Gynaecol

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“…CSP is a condition with a possible long term morbidity [7] and even a life-threatening event. There are still doubts about treatment options, ranging from expectant management [8] to surgical approach [9]. The prognosis for uneventful term pregnancy is very poor, with only anecdotal reports regarding vital term CSP with favorable fetal outcome [10].…”

Section: Discussionmentioning

confidence: 99%

Repeated cesarean scar pregnancy – Case report

Bolanča¹,

Butorac²,

Eljuga³

et al. 2016

Clin. Exp. Obstet. Gynecol.

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Cesarean scar pregnancy (CSP) is a rare location of an ectopic pregnancy implanted within a scar from previous cesarean section, separated from the endometrial cavity. The prevalence ranges from 1:1,800 to 1:2,226 pregnancies. It is a potential life-threatening condition, and if misdiagnosed, can cause serious maternal morbidity from uterine rupture with massive hemorrhage and even death. Until now, no universal treatment guidelines have been established, with treatment options ranging from systemic or local injection of methotrexate (MTX), suction curettage under ultrasound control to surgical treatment, including hysteroscopy and wedge resection of the ectopic pregnancy, via laparotomy or laparoscopy. The authors present a case of a 42-year old woman with two consecutive CSPs. First CSP was unsuccessfully treated conservatively, followed by ultrasound guided vacuum aspiration of the uterine cavity. Second CSP was treated by laparotomy and a wedge excision of a CSP and repair of a scar with interrupted sutures. The authors also discuss diagnostic pitfalls and treatment modalities.

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