First-Trimester Cesarean Scar Pregnancy Evolving Into Placenta Previa/Accreta at Term

Nagi, Jara Ben; Ofili-Yebovi, D.; Marsh, Mike

doi:10.7863/jum.2005.24.11.1569

Cited by 86 publications

(70 citation statements)

References 10 publications

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“…In transabdominal and transvaginal US, myometrial defect seen especially in the region of uterine scar and the protrusion by the placenta toward this region can be early findings of placenta accreta (8). Ben Nagi et al (9) defended that cesarean scar pregnancy in the first trimester could turn into placenta accreta and reported the clinical and ultrasonographic course of this conversion in a case.…”

Section: Discussionmentioning

confidence: 99%

A Case of a Placenta Percreta Presenting with Severe Vaginal Bleeding Following Early Second Trimester Pregnancy Termination

Kütük¹,

Dolanbay²,

Özdemir³

et al. 2015

Erciyes Med J

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A 14-week pregnant woman was admitted to the hospital for pregnancy termination because of early rupture of membranes. Dilatation and curettage were performed because the placenta did not separate spontaneously after fetus evacuation. The placenta could not be extracted and severe vaginal bleeding occurred. The patient's condition deteriorated. Placenta percreta was detected intraoperatively. Emergency hysterectomy was performed. Because of the high risk of maternal morbidity and mortality, it is important to consider placenta percreta in the presence of prolonged first and second trimester pregnancy termination, especially in those patients with a history of uterine surgery.

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Section: Discussionmentioning

confidence: 99%

A Case of a Placenta Percreta Presenting with Severe Vaginal Bleeding Following Early Second Trimester Pregnancy Termination

Kütük¹,

Dolanbay²,

Özdemir³

et al. 2015

Erciyes Med J

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“…6 Risk factors for an abnormal placentation include prior cervical dilatation and curettage, endometritis, submucous myomas and uterine scars defect after cesarean section. [7][8][9] The relationship between abnormal placentation and previous cesarean section was investigated by Clark et al…”

Section: Discussionmentioning

confidence: 99%

Haemorrhage in early pregnancy: unusual presentation of placenta increta as complete mole

Varwatte

Fonseca

Kharat

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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“…In CSP where the growth is towards the uterine cavity continuation of the pregnancy is possible uterine rupture in the third trimester and maternal death from antenatal intraoperative, or postoperative hemorrhage have also been reported, showing the risk of pregnancy continuation to be very high. 8 Different techniques have been described and these include: systemic administration of Methotrexate (MTX), injection of embryocides (such as MTX, potassium chloride) directly into the gestation sac or a combination of feticide followed by systemic administration of drugs. Patient and the family members have to be counseled that the weak myometrial scar can dehisce and rupture during treatment as well as the need for prolonged follow up (due to the placental implantation on mainly fibrous tissue and hence absorption of the gestation sac is extremely slow, and they are educated regarding the same.…”

Section: Discussionmentioning

confidence: 99%

Ceasarean scar pregnancies, diagnosis and management

Dhillon

Sood

2018

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONCSP is an iatrogenic complication of a previous ceasarean delivery. The true incidence of CSP is unknown. Incidence of CSP is currently estimated at 1:1800-2200 pregnancies.1,2 With a history of a previous cesarean delivery, it is estimated that 0.15% of all pregnancies will be followed by a CSP in the woman's next pregnancy. 3Although rare , the possibility of a recurrent CSP is also possible and greater awareness on part of the clinician and the patient is essential .Unfortunately, CSPs are often misdiagnosed as abortions in progress, ectopic and cervical pregnancies .CSP can have grave consequences in all the three trimesters for the patient if not recognized early or appropriately treated.There are two types of CSP which have been reported. One in which there is a deep implantation in a cesarean scar defect towards the bladder and the abdominal cavity and the second type which involves an implantation ABSTRACT Background: Objective of present study was to describe evaluation and management of pregnancies implanted into uterine Cesarean section scars, Ceasarean scar pregnancies (CSP), is defined as gestational sac implanted in the myometrium at the site of a previous ceasarean scar. Also known as Ceasarean ectopic pregnancy. Methods: In all antenatal patients attending the antenatal outpatient department of a tertiary care service hospital a transvaginal sonography was done for determining the gestational age as well as the viability of the pregnancy. In all patients with a history of previous Cesarean section(s), special effort was made to assess the possibility of implantation into the uterine scar by means of an early transvaginal and colour doppler ultrasound. Results: Twelve Cesarean section scar pregnancies were diagnosed in a five-year period, of a tertiary care service hospital. Five (42%) patients with Cesarean scar pregnancies were treated surgically, four patients medically (33%), and two patients expectantly (17%) and one patient opted to continue the pregnancy. Surgical management was successful in all cases, although two of five (40%) women suffered bleeding (300-500ml). In the group of women who were managed medically the success rate was 3/4(75%). Expectant management was successful in one of two cases (50%). One patient who opted to continue pregnancy, underwent a ceasarean hysterectomy at 33 weeks of gestation for placenta accreta. Conclusions: Incidence of ceasarean section scar pregnancies is increasing as is the increasing rate of ceasarean deliveries. A high index of suspicion in all cases of post ceasarean pregnancies, coupled with early transvaginal ultrasonography along with colour doppler confirmation and institution of early and individualized treatment, optimizes the clinical outcome. Although rare, the patient and her relatives must be made aware of the possibility of recurrent CSP.

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First-Trimester Cesarean Scar Pregnancy Evolving Into Placenta Previa/Accreta at Term

Cited by 86 publications

References 10 publications

A Case of a Placenta Percreta Presenting with Severe Vaginal Bleeding Following Early Second Trimester Pregnancy Termination

A Case of a Placenta Percreta Presenting with Severe Vaginal Bleeding Following Early Second Trimester Pregnancy Termination

Haemorrhage in early pregnancy: unusual presentation of placenta increta as complete mole

Ceasarean scar pregnancies, diagnosis and management

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