scholarly journals Clinical characteristics and salvage management of persistent cesarean scar pregnancy

2017 ◽  
Vol 43 (8) ◽  
pp. 1293-1298 ◽  
Author(s):  
Xue Ying ◽  
Wei Zheng ◽  
Li Zhao ◽  
Mi Zhou ◽  
Zhengyun Chen
2021 ◽  
Author(s):  
Panpan Tang ◽  
Xiaomao Li ◽  
Wenwei Li ◽  
Yunhui Li ◽  
Yu Zhang ◽  
...  

Abstract Objective: To investigate the distribution and its variation trend of the ectopic site and the clinical characteristics of cesarean scar pregnancy, to provide clues for further clinical practice. Methods: 3915 patients are brought into our study. To calculate the distribution of the implantation of ectopic pregnancy. Then analyze with trend χ2 test and calculate the quantity of each type of ectopic pregnancy during the year 2012-2015 and the year 2016-2019 to analyze the variation trend. Results: 1. The proportion of each site of ectopic pregnancy is as following: tubal pregnancy (84.70%), ovarian pregnancy (1.56%), cesarean scar pregnancy (8.63%), abdominal pregnancy (0.61%), cornual pregnancy (2.68%), cervical pregnancy (0.49%), heterotopic pregnancy (0.43%). 2. Through trend χ2 test, the ratio of cesarean scar pregnancy to ectopic pregnancy showed an increasing trend(P=0.005). From the year 2012-2015 to the year 2016-2019, the ratio of cesarean scar pregnancy to ectopic pregnancy increased from 5.74% to 11.81%(P<0.001). 3.72.78%(246/338) cesarean scar pregnancy patients had cesarean delivery once, 25.15%(85/338) had cesarean delivery twice, and 2.07%(7/338) had cesarean delivery three times. 80.18%(271/338) had aborted before. The most common clinical manifestations are amenorrhea (98.52%), abdominal pain (25.74%) and vaginal bleeding (67.76%), the most common sign is hysterauxesis (46.75%). Conclusion: As the increasing of the ratio of cesarean scar pregnancy to ectopic pregnancy, the cesarean delivery rate should be decreased to decrease the morbidity of cesarean scar pregnancy.


2011 ◽  
Vol 31 (4) ◽  
pp. 450-452
Author(s):  
Yu-huan LIU ◽  
Ning HUI ◽  
Ming-juan XU ◽  
Hui ZHANG ◽  
Rui GUAN ◽  
...  

Author(s):  
Omer Tammo ◽  
Hacer Uyanikoglu ◽  
İsmail Koyuncu

Aim and Objective: This study aimed to explore the plasma free amino acid (FAA) and carnitine levels in pregnant women with cesarean scar pregnancy (CSP), and to compare them with those of healthy pregnant women. Materials and Methods: This prospective and randomized controlled study was conducted in patients admitted to Harran University Medical Faculty Hospital Obstetrics Clinic between January 2018 and January 2019. A total of 60 patients were included in the study, and the patients were divided into two groups: CSP group (n = 30) and healthy pregnant group as the control group (n = 30). The blood samples were taken from the participants between 7 - 12 weeks of gestation. Twentyseven carnitines and their esters and 14 FAAs were analysed by liquid chromatography – mass spectrometry (LC-MS/MS). Results: The mean plasma concentrations of some carnitines, including C2, C5, C5-OH, C5-DC, C6, C8-1, C12, C14, C14- 1, C14-2, C16, C16-1, C18, and C18-1 were significantly higher in CSP group than in the control group. However, other carnitines, including C0, C3, C4, C4-DC, C5-1, C6-DC, C8, C8-DC, C10, C10-1, C18-1-OH, and C18-2 were similar in both groups. The plasma levels of some FAAs, including Methyl Glutaryl, Leu, Met, Phe, Arg, Orn, and Glu values were significantly higher in CSP group than in the control group. However, there was no statistically significance in other FAA levels, including Val, Asa, Tyr, Asp, Ala, Cit, and Gly between the two groups. Additionally, Pearson’s correlation analysis showed that there were significantly positive correlations between many FAA and carnitine values. Conclusion: Since several plasma carnitine and FAA levels were higher in CSP group than in the control group, we think that scar pregnancy increases metabolic need for myometrial invasion. Also, we think that these results may be useful in clinical practice for CSP diagnosis.


2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096437
Author(s):  
Hongan Tian ◽  
Shunzhen Li ◽  
Wanwan Jia ◽  
Kaihu Yu ◽  
Guangyao Wu

Objective To observe the hemostatic effect of prophylactic uterine artery embolization (UAE) in patients with cesarean scar pregnancy (CSP) and to examine the risk factors for poor hemostasis. Methods Clinical data of 841 patients with CSP who underwent prophylactic UAE and curettage were retrospectively analyzed to evaluate the hemorrhage volume during curettage. A hemorrhage volume ≥200 mL was termed as poor hemostasis. The risk factors of poor hemostasis were analyzed and complications within 60 days postoperation were recorded. Results Among the 841 patients, 6.30% (53/841) had poor postoperative hemostasis. The independent risk factors of poor hemostasis were gestational sac size, parity, embolic agent diameter (>1000 μm), multivessel blood supply, and incomplete embolization. The main postoperative complications within 60 days after UAE were abdominal pain, low fever, nausea and vomiting, and buttock pain, with incidence rates of 71.22% (599/841), 47.44% (399/841), 39.12% (329/841), and 36.39% (306/841), respectively. Conclusions Prophylactic UAE before curettage in patients with CSP is safe and effective in reducing intraoperative hemorrhage. Gestational sac size, parity, embolic agent diameter, multivessel blood supply, and incomplete embolization of all arteries supplying blood to the uterus are risk factors of poor hemostasis.


Author(s):  
Ilan E. Timor-Tritsch ◽  
W. Meredith McDermott ◽  
Ana Monteagudo ◽  
Giuseppe Calί ◽  
Fabiana Kreines ◽  
...  

Author(s):  
Conrado Milani Coutinho ◽  
Laure Noel ◽  
Veronica Giorgione ◽  
Lígia Conceição Assef Marçal ◽  
Amar Bhide ◽  
...  

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