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. 2022 Jul;48(7):1683-1690.
doi: 10.1111/jog.15258. Epub 2022 Apr 5.

Cesarean scar pregnancy with expectant management

Liye Fu  1   2 , Yingchun Luo  3 , Jinbai Huang  1   4
Affiliations

Cesarean scar pregnancy with expectant management

Liye Fu et al. J Obstet Gynaecol Res. 2022 Jul.

Abstract

Aim: This study aimed to ascertain whether the lower anterior myometrial thickness (MT) between the bladder and the gestational sac in early pregnancy can be used to predict clinical outcomes in women with cesarean scar pregnancy (CSP) after expectant management.

Methods: We retrospectively analyzed the clinical data and early pregnancy ultrasound images of 21 patients who received expectant management for CSP. Among them, 11 patients with serious complications during pregnancy, such as intraoperative blood loss ≥1000 mL or with severe forms of morbidly adherent placenta (MAP; placenta increta or placenta percreta), were assigned to group A. The remaining 10 patients without serious complications during pregnancy were assigned to group B. The difference in MT between groups A and B was analyzed using nonparametric Mann-Whitney U test.

Results: There was a statistically significant difference in MT between the groups (U = 20.000, p = 0.013). The area under the receiver operating characteristics (ROC) curve was 0.818, and the optimal cut-off value for MT was 3.3 mm.

Conclusion: Lower anterior MT around the gestational sac was correlated with severe complications, such as massive intraoperative bleeding or severe forms of MAP in patients with CSP.

Keywords: cesarean scar pregnancy; expectant management; intraoperative blood loss; morbidly adherent placenta; ultrasound examination.

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Conflict of interest statement

None declared.

Figures

FIGURE 1
FIGURE 1
Myometrial thickness (red line) in early pregnancy was 2 mm in case no. 5 from group A, which had MAP during late pregnancy
FIGURE 2
FIGURE 2
Myometrial thickness (red line) in early pregnancy was 7 mm in case no. 5 from group B, which had a normal placenta during late pregnancy
FIGURE 3
FIGURE 3
Difference of myometrial thickness (MT) between group A (with serious complications) and group B (without serious complications)
FIGURE 4
FIGURE 4
Predictive value of myometrial thickness (MT) for nonserious complications. Receiver‐operating characteristics (ROC) curves were plotted for MT
See this image and copyright information in PMC

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