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. 2022 Aug 16;22(1):644.
doi: 10.1186/s12884-022-04965-9.

Analysis of pregnancy outcomes following surgical treatment of cesarean scar pregnancy

Zongxu Xu  1 , Chengcheng Sheng  1 , Qing Yang  1 , Jun Wang  2
Affiliations

Analysis of pregnancy outcomes following surgical treatment of cesarean scar pregnancy

Zongxu Xu et al. BMC Pregnancy Childbirth. .

Abstract

Purpose: To investigate the surgical treatment approaches for patients with Cesarean scar pregnancy (CSP) and the effects on subsequent pregnancy.

Methods: CSP patients admitted to Shengjing Hospital of China Medical University from January 2013 to December 2018 were retrospectively analyzed to collect their clinical characteristics, and follow-up of postoperative pregnancies.

Results: A total of 1126 CSP patients were enrolled in this study, including 595 (52.84%) CSP type I, 415 (36.86%) CSP type II, and 116 (10.30%) CSP type III cases. There were significant differences between the three types of patients in terms of β-HCG levels, gestational sac diameter, clinical symptoms and presence of fetal heartbeat at diagnosis (P < 0.01). Among these, 89.90% of CSP type I, 88.90% of CSP type II and 50% of CSP type III patients were treated with hysteroscopic lesion excision, 7.9% of CSP type I and 2.2% of CSP type II patients underwent ultrasound-monitored curettage, and the remaining patients underwent lesion excision and and simultaneous repair of excised lesions by different routes (trans-laparoscopic, transabdominal or transvaginal methods). And 5.55% of CSP type I, 22.65% of CSP type II and 43.10% of CSP type III patients were treated with adjunctive uterine artery embolization (UAE). The patients were followed up for more than 2 years after surgery. Among the 166 re-pregnancies, 58 (34.94%) were normal pregnancies, 17 patients reoccurred with CSP, the recurrent rate of CSP was 10.24%. All 58 normal pregnancies were terminated by cesarean section, with a mean gestational week of delivery of (38.36 ± 2.25) weeks, a mean birth weight of (3228.45 ± 301.96)g, and the postnatal Apgar score was (9.86 ± 0.23) points at 1 min and all 5 min were 10 points. Logistic regression analysis suggested that the number of previous cesarean deliveries was a risk factor for recurrent CSP (RCSP) (OR = 10.82, 95% CI: 2.52-46.50, P = 0.001).

Conclusions: The type of CSP is related to β-HCG values, presence of fetal heartbeat, gestational sac diameter and clinical symptoms. Hysteroscopic therapy is a commonly used surgical procedure and UAE is often used as an adjuvant treatment. For subsequent pregnancies, the number of previous cesarean deliveries is a risk factor for recurrent CSP.

Keywords: Cesarean scar pregnancy; Follow-up; Subsequent pregnancy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Number of enrolled cesarean scar pregnancies at Shengjing Hospital of China Medical University during the years from 2013 to 2018. CSP, Cesarean scar pregnancy
Fig. 2
Fig. 2
Follow-up of subsequent pregnancy after CSP treatment in patients enrolled in this study. CSP, Cesarean scar pregnancy
See this image and copyright information in PMC

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References

    1. Ash A, Smith A, Maxwell D. Caesarean scar pregnancy. BJOG. 2007;114:253–263. doi: 10.1111/j.1471-0528.2006.01237.x. - DOI - PubMed
    1. Zhang C, Zhang Y-Q, He J, Zhang L. Outcomes of subsequent pregnancies in patients following treatment of cesarean scar pregnancy with high intensity focused ultrasound followed by ultrasound-guided dilation and curettage. Int J Hyperthermia. 2019;36:926–931. - PubMed
    1. Liu G-Q, Wu J-C, Cao J, Xue Y-P, Dai C-C, Xu J, et al. Comparison of three treatment strategies for cesarean scar pregnancy. Arch Gynecol Obstet. 2017;296:383–389. doi: 10.1007/s00404-017-4426-5. - DOI - PubMed
    1. Miller R, Timor-Tritsch IE, Gyamfi-Bannerman C. Society for Maternal-Fetal Medicine (SMFM) Consult Series #49: Cesarean scar pregnancy. Am J Obstet Gynecol. 2020;222:B2–B14. doi: 10.1016/j.ajog.2020.01.030. - DOI - PubMed
    1. Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management. Obstet Gynecol. 2006;107:1373–1381. doi: 10.1097/01.AOG.0000218690.24494.ce. - DOI - PubMed

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