Outcomes of subsequent pregnancies in patients following treatment of cesarean scar pregnancy with high intensity focused ultrasound followed by ultrasound-guided dilation and curettage

Zhang, Cai; Zhang, Yuqi; He, Jia

doi:10.1080/02656736.2019.1654619

Cited by 25 publications

(21 citation statements)

References 21 publications

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“…Here, we report a recurrence rate of 8.3% in 24 individual subsequent pregnancies, which is similar to that cited in other studies, suggesting that the risk of developing recurrent CSP is low 4 . We also found that 8.3% of women with a history of CSP subsequently developed an ectopic pregnancy, which is lower than the rate of 13% reported in a similar population in another study 5 . However, the rate of ectopic pregnancy in our study is higher compared with the general incidence of ectopic pregnancy in developed countries (about 2%).…”

Section: Figuresupporting

confidence: 90%

Subsequent pregnancy outcomes and recurrence in women with previous Cesarean scar pregnancy: a 3‐year follow‐up study in a tertiary hospital

Tang

Liu

et al. 2021

Ultrasound in Obstet & Gyne

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Section: Figuresupporting

confidence: 90%

Subsequent pregnancy outcomes and recurrence in women with previous Cesarean scar pregnancy: a 3‐year follow‐up study in a tertiary hospital

Tang

Liu

et al. 2021

Ultrasound in Obstet & Gyne

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“…To date there were very few studies investigating the association of caesarean scar pregnancy with subsequent fertility in the literature. This could be because that the majority of women with a history of caesarean scar pregnancy are afraid of developing recurrent caesarean scar pregnancy, resulting in women not attempting to become pregnant again, even the rate of recurrent caesarean scar pregnancy is relatively low (8)(9)(10)(11). A six year follow-up study led by Nagi reported that three (12.5%) women did not become pregnant, in a total of 24 women treated for caesarean scar pregnancy who attempted to conceive (8).…”

Section: Discussionmentioning

confidence: 99%

“…Although non-surgical management of caesarean scar pregnancy is a more common option in western countries such as the United States of American ( 2 , 7 ), in our hospital (maybe also in most hospitals in China), hysteroscopy is the most common option for cesarean scar pregnancy treatment. A recent study reported that high intensity focused ultrasound (HIFU) followed by ultrasound guided dilation and curettage (D&C) treatment in previous caesarean scar pregnancy seems to have a lower risk in recurrent caesarean scar pregnancy and other complications in subsequent pregnancies ( 10 ). However, this finding was not seen in other studies ( 7 , 9 , 11 ).…”

Section: Discussionmentioning

confidence: 99%

“…Currently, data on subsequent outcomes in women with a history of caesarean scar pregnancy have not been well described. Although a relatively good outcome with a live birth in subsequent pregnancies and a lower recurrence rate of caesarean scar pregnancy has been reported (8)(9)(10)(11), our recent study suggested that there may be a potential risk for developing complicated pregnancies, such as gestational diabetes mellitus (GDM) (11). Because of the potential risk of developing recurrent caesarean scar pregnancies, most women with a history of caesarean scar pregnancy did not attempt to have a subsequent pregnancy.…”

Section: Introductionmentioning

confidence: 99%

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Subsequent Fertility in Women Treated for Caesarean Scar Pregnancy With Hysteroscopy: A 5-Year Follow-Up Descriptive Study in a Tertiary Hospital

et al. 2021

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ObjectiveThe outcomes of subsequent pregnancies and fertility in women with a history of caesarean scar pregnancy have not been well described. In this study, we followed up 149 women with a history of caesarean scar pregnancy and analysed the effect on their fertility.Methods149 women with a history of caesarean scar pregnancy were followed up for five years. Of them, 53 women had unprotected sexual intercourse attempting to become pregnant again. Data including clinical parameters and treatment options at the time of diagnosis of caesarean scar pregnancy, and the outcomes in subsequent pregnancy were collected. In addition, a questionnaire about the menstrual cycle after treatment was voluntarily completed by these women.ResultsOf the 53 women, 46 (84%) women had a subsequent pregnancy, while seven (14%) women did not. There was no association between the clinical parameters in previous caesarean scar pregnancy or treatment and future fertility. From the questionnaire, there was no difference seen in the length of the menstrual cycle and menses between the two groups. However, a higher number of women with light menstrual bleeding were seen in women without a subsequent pregnancy (67%), compared with women who did (28%). In addition, six women (13%) who had a subsequent pregnancy experienced foetus death in the first trimester.ConclusionWe reported that 14% of women with a history of cesarean scar pregnancy did not have a subsequent pregnancy, after unprotected sexual intercourse for more than two years. Light menstrual bleeding after treatment may be associated with this adverse effect. Our findings need to be further investigated with large sample size.

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“…A total of 358 articles were identified; 122 were assessed with respect to their eligibility for inclusion and 44 studies were included in the systematic review (Table 1, Figure 1). 9,10,21‐61 These studies included 3598 women with a prior CSP; of these, information on subsequent pregnancy was available for 592 women.…”

Section: Resultsmentioning

confidence: 99%

Reproductive outcome after cesarean scar pregnancy: A systematic review and meta‐analysis

Morlando

Buca

Timor‐Tritsch

et al. 2020

Acta Obstet Gynecol Scand

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Introduction To evaluate subsequent reproductive among women with a prior cesarean scar pregnancy (CSP). Material and methods MEDLINE, Embase and ClinicalTrials.gov databases were searched. Inclusion criteria were women with a prior CSP, defined as the gestational sac or trophoblast within the dehiscence/niche of the previous cesarean section scar or implanted on top of it. The primary outcome was the recurrence of CSP; secondary outcomes were the chance of achieving a pregnancy after CSP, miscarriage, preterm birth, uterine rupture and the occurrence of placenta accreta spectrum disorders. Subgroup analysis according to the management of CSP (surgical vs non‐surgical) was also performed. Random effect meta‐analyses of proportions were used to analyze the data. Results Forty‐four studies (3598 women with CSP) were included. CSP recurred in 17.6% of women. Miscarriage, preterm birth and placenta accreta spectrum disorders complicated 19.1% (65/341), 10.3% (25/243) and 4.0% of pregnancies, and 67.0% were uncomplicated. When stratifying the analysis according to the type of management, CSP recurred in 21% of women undergoing surgical and in 15.2% of those undergoing non‐surgical management. Placenta accreta spectrum disorders complicated 4.0% and 12.0% of cases, respectively. Conclusions Women with a prior CSP are at high risk of recurrence, miscarriage, preterm birth and placenta accreta spectrum. There is still insufficient evidence to elucidate whether the type of management adopted (surgical vs non‐surgical) can impact reproductive outcome after CSP. Further large, prospective studies sharing an objective protocol of prenatal management and long‐term follow up are needed to establish the optimal management of CSP and to elucidate whether it may affect its risk of recurrence and pregnancy outcome in subsequent gestations.

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Outcomes of subsequent pregnancies in patients following treatment of cesarean scar pregnancy with high intensity focused ultrasound followed by ultrasound-guided dilation and curettage

Abstract: Zhang (2019) Outcomes of subsequent pregnancies in patients following treatment of cesarean scar pregnancy with high intensity focused ultrasound followed by ultrasound-guided dilation and curettage,

Cited by 25 publications

References 21 publications

Subsequent pregnancy outcomes and recurrence in women with previous Cesarean scar pregnancy: a 3‐year follow‐up study in a tertiary hospital

Subsequent pregnancy outcomes and recurrence in women with previous Cesarean scar pregnancy: a 3‐year follow‐up study in a tertiary hospital

Subsequent Fertility in Women Treated for Caesarean Scar Pregnancy With Hysteroscopy: A 5-Year Follow-Up Descriptive Study in a Tertiary Hospital

Reproductive outcome after cesarean scar pregnancy: A systematic review and meta‐analysis

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