Natural history of Cesarean scar pregnancy on prenatal ultrasound: the crossover sign

Abstract Background This article reports a unique case of cesarean scar pregnancy, demonstrating importance of early management and diagnosis. Case presentation A 30-year-old pregnant woman with prior history of two cesarean sections found to have cesarean scar pregnancy at approximately 13 weeks’ gestation and underwent a gravid hysterectomy. Conclusions While rare, cesarean scar pregnancies should be considered on the differential diagnosis of any pregnant patient with history of cesarean section who presents in early pregnancy with vaginal bleeding and/or cramping. Given the increased rates of cesarean sections in the times of COVID-19, one may anticipate seeing more cases of cesarean scar pregnancies.

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Identifying Risk Factors and Incidence Rates for Recurrent Cesarean Scar Pregnancy: A Nested Case-Control Study

10.21203/rs.3.rs-184582/v1 ◽

2021 ◽

Author(s):

Sili He ◽

Fei Zeng ◽

Zhiwen Fan ◽

Qi Tian ◽

Jianfa Jiang ◽

...

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Incidence Rates ◽

Cesarean Scar Pregnancy ◽

Cesarean Scar ◽

Induced Abortions ◽

History Of ◽

Group 2 ◽

Nested Case Control

Abstract Background: Cesarean scar pregnancy (CSP) is a rare and dangerous ectopic pregnancy. CSP is a late severe complication of cesarean section. In recent years, with the introduction of the comprehensive second birth policy in China, the incidence of CSP and recurrent CSP has increased. However, there are no clear data available regarding the risk factors related to recurrent CSP in the literature. To identify risk factors and incidence rates for recurrent CSP. Methods: A total of 1000 CSP patients were followed up for 66 ± 19.5 months. Among them, 86 developed recurrent CSP during the follow-up period (group 1), and the remaining without recurrence were group 2. The clinical data of these cases were reviewed in this retrospective study. Results: The incidence rate of recurrent CSP is 8.6%, and the risk factors were a history of ectopic pregnancy and prior abortions. The incidence of RCSP in patients >-35-years-old was significantly lower than that in patients <35-years-old (P=0.031).Conclusions: Previous ectopic pregnancy is an independent risk factor for RCSP. Additionally, the higher the number of induced abortions, the higher the incidence of RCSP.

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Scar Pregnancy a Diagnostic Conundrum: A Case Report

Journal of Nepal Medical Association ◽

10.31729/jnma.5202 ◽

2021 ◽

Vol 59 (235) ◽

Author(s):

Manoj Pokhrel ◽

Shreedhar Prasad Acharya ◽

Jyotshna Sharma ◽

Meena Thapa

Keyword(s):

Past History ◽

Transvaginal Sonography ◽

Cesarean Scar Pregnancy ◽

Cesarean Scar ◽

Uterine Incision ◽

History Of ◽

Gestational Sac ◽

High Index Of Suspicion ◽

Prompt Diagnosis ◽

Previous Cesarean

Cesarean scar pregnancy is a rare form of ectopic pregnancy which may lead to uterine rupture and catastrophic hemorrhage. We report a case of cesarean scar pregnancy in a 35-year-old female with the past history of cesarean section presented with complaints of amenorrhoea for 6 weeks and non-specific pain. Two Transvaginal sonography was done 48 hours apart which suggested a cesarean scar pregnancy in one and cervical pregnancy on the other. Magnetic Resonace Imaging showed a well-defined cystic lesion of (21x19)mm2 embedded within the previous cesarean scar which confirmed the diagnosis of cesarean scar pregnancy. Laparotomy unveiled uterus around 6 weeks size and a (3x3)cm2 bulge was noted at the site of previous scar in lower uterine segment, where a small incision was given and the gestational sac was removed following which the uterine incision was closed with 2-0 polyglactin suture. High index of suspicion and prompt diagnosis is ofparamount for reducing morbidity and mortality.

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Recurrent Cesarean Scar Ectopic Pregnancy Treated with Systemic Methotrexate

Case Reports in Obstetrics and Gynecology ◽

10.1155/2017/9536869 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Chima Ndubizu ◽

Rodney A. McLaren ◽

Sandra McCalla ◽

Mohamad Irani

Keyword(s):

Ectopic Pregnancy ◽

Complete Resolution ◽

Transvaginal Ultrasound ◽

Rare Event ◽

Artery Embolization ◽

Cesarean Scar Pregnancy ◽

Cesarean Scar ◽

Cesarean Deliveries ◽

Beta Human Chorionic Gonadotropin ◽

History Of

Cesarean scar pregnancy (CSP) is a rare event; however its incidence has been rising due to the increasing rates of cesarean deliveries. The majority of cases present with signs or symptoms requiring surgery, which often results in hysterectomy. The recurrence of CSP is even rarer with only few cases which have been reported. This is a report of recurrent cesarean scar ectopic pregnancy (RCSP) that was promptly diagnosed and managed with only systemic methotrexate. This was a 30-year-old woman, with a history of two prior cesarean deliveries followed by a CSP, who presented at 5 weeks and 3 days of gestation for her first prenatal visit. Transvaginal ultrasound revealed a RCSP. Her serum beta-human chorionic gonadotropin (β-hCG) level was 54,295 IU/L. The first CSP, which was diagnosed at a later stage, was treated with uterine artery embolization and systemic methotrexate leading to complete resolution within 10 weeks. The current ectopic was treated with two doses of systemic methotrexate; her serum β-hCG reached undetectable levels within 7 weeks. Thus, patients with a history of prior CSP should be carefully monitored with transvaginal ultrasound during subsequent pregnancies to allow early diagnosis of RCSP, which could then be treated conservatively.

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