Therapeutic approach for the cesarean scar pregnancy

Fu, Liping

doi:10.1097/md.0000000000010476

Cited by 24 publications

(18 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A new USS grading system for CSP was proposed recently by shin-Yu Lin et al, 2018 [13]. This categorised them into four grades depending upon the ultrasound description of the extent of entrenchment of GS through the Myometrium (Figure 2).…”

Section: Discussionmentioning

confidence: 99%

Live Cesarean Scar Pregnancy: A Case Report

Dua¹,

Amin²,

Amin³

2020

CROGR

View full text Add to dashboard Cite

Introduction: The overall incidence of Cesarean scar pregnancy is increasing due to Cesarean rates. This life-threatening condition has been historically managed in various ways as no single modality is reliable enough. We report this case of live CSP managed initially with Fetocide followed by Methotrexate but requiring Surgical management later on. Presentation: A 32 years old para 5 with four previous Cesarean sections was diagnosed with live CSP. HCG level was 76,619. The initial management was fetocide with KCL followed by Methotrexate. The treatment was considered successful in view of appropriate reduction in serum HCG levels. The woman required surgical management 10 weeks after the initial management, but the blood loss was minimal. Discussion: A CSP may be asymptomatic or present with non-specific symptoms. The rate of initial misdiagnosis is as high as 76%. TVUSS enables correct CSP diagnosis and implementation of minimally invasive effective treatment. HCG levels can affect the overall outcome, but medical management can be considered even with high HCG levels. Conclusion: CSP is a life-threatening condition, therefore timely diagnosis and appropriate management is crucial. Medical management can be considered in most cases even with high HCG, but management has to be tailored according to the patient. Close follow up of patient after Medical treatment is important as they may require further intervention.

show abstract

Section: Discussionmentioning

confidence: 99%

Live Cesarean Scar Pregnancy: A Case Report

Dua¹,

Amin²,

Amin³

2020

CROGR

View full text Add to dashboard Cite

show abstract

“…In contrast, proper diagnosis and management of CSSP prevent subsequent uterine rupture, internal hemorrhage and emergency hysterectomies [6]. So, this case report represents the importance of early diagnosis and management of CSSP cases.…”

Section: Introductionmentioning

confidence: 88%

“…Previous cesarean delivery is the only risk factor for CSSP and the incidence of CSSP has increased due to the increased rates of cesarean deliveries and the improved ultrasound diagnostic tools [6].…”

Section: Introductionmentioning

confidence: 99%

Cesarean section scar pregnancy

Naser¹,

Abdelazim²,

Abu-Faza³

2018

jogi

View full text Add to dashboard Cite

Introduction: Cesarean section scar pregnancy (CSSP) occurs due to implantation of the gestational sac over the previous cesarean section or hysterotomy scars. Case description: A 40-year-old woman referred to our hospital with a missed period for 5 weeks +3 days, mild vaginal spotting and β-hCG 5770 mIU/ml as a case of ectopic pregnancy. The repeated β-hCG was 8797 mIU/ml and the transvaginal ultrasound (TVS) showed the gestational sac located in the lower anterior quadrant of the uterus behind the urinary bladder (only a thin layer of myometrium separating it from the bladder), close to the internal cervical os and the site of the previous scars. The case was diagnosed as CSSP and managed according to the hospital protocol by systemic multi-dose methotrexate (MTX) with follow-up using β-hCG, TVS and complete blood count (CBC). When the β-hCG result was found to be 60.66 mIU/ml, and the repeated weekly TVS showed a progressive decrease in the size of the gestational sac, the studied woman was discharged from the hospital for follow-up in the outpatient department (OPD). Conclusions: There is no single best treatment to terminate the CSSP, and the procedure with the fewest complications should be selected. Several authors support systemic multi-dose MTX treatment for CSSP with follow-up using TVS, β-hCG and CBC.

show abstract

“…For example, cesarean scar ectopic pregnancy, one of the most complicated abnormal pregnancies, can be managed by ultrasound-guided curettage because it is relatively simple and inexpensive compared to the hysteroscopy approach. [ 5 ]…”

mentioning

confidence: 99%

“…[ 1 ] However, it is believed to be a more effective method for the diagnosis of endometrial disorders. Regarding cesarean scar ectopic pregnancy, hysteroscopy provides a clear view for us, making it easy to identify the range of affected tissues, and clean the pregnancy tissue,[ 5 ] compared to ultrasound does. Hysteroscopy might be recommended as a first-line treatment modality for patients with a cesarean scar ectopic pregnancy, although the different opinions are raised.…”

mentioning

confidence: 99%

A powerful value of hysteroscopy

Wang

2018

Gynecol Minim Invasive Ther

View full text Add to dashboard Cite

Therapeutic approach for the cesarean scar pregnancy

Cited by 24 publications

References 16 publications

Live Cesarean Scar Pregnancy: A Case Report

Live Cesarean Scar Pregnancy: A Case Report

Cesarean section scar pregnancy

A powerful value of hysteroscopy

Contact Info

Product

Resources

About