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Multicenter Study
. 2021 Aug;75(4):439-445.
doi: 10.18926/AMO/62395.

Clinical Course of 60 Cesarean Scar Pregnancies

Takashi Mitsui  1 , Sakurako Mishima  1 , Kazumasa Tani  1 , Jota Maki  1 , Eriko Eto  1 , Kei Hayata  1 , Hisashi Masuyama  1
Affiliations
Free article
Multicenter Study

Clinical Course of 60 Cesarean Scar Pregnancies

Takashi Mitsui et al. Acta Med Okayama. 2021 Aug.
Free article

Abstract

Early diagnosis and therapy are important in a cesarean scar pregnancy (CSP), which can cause uterine rupture with resultant massive bleeding. However, there are some reports of CSPs continued to term. The optimal management of CSPs remains unclear; therefore, we investigated the clinical courses of CSPs diagnosed and treated at perinatal institutions in the Chugoku and Shikoku regions of Japan. We enrolled 60 women diag-nosed with CSP at 21 institutions from January 2006 to December 2015. Of the 60 women diagnosed with CSP, 57 were treated. Pregnancy was terminated in 48 women and continued in 9. Thirteen women underwent transabdominal hysterectomy; they experienced no postoperative complications or allogeneic blood transfu-sion. Nine women received therapies such as dilation and curettage, and 26 received non-surgical therapies such as methotrexate and topical administration of potassium chloride. Among 9 women who chose to con-tinue with their CSP, 7 successfully delivered newborns, 2 had uterine ruptures in the second trimester, and all women required transabdominal hysterectomy. Diagnosis and therapy in the first trimester of pregnancy are important in the management strategy of a CSP. When continuing a CSP, the risk of uterine rupture and trans-abdominal hysterectomy must be considered.

Keywords: cesarean scar pregnancy; hysterectomy; methotrexate; potassium chloride; uterine rupture.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

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