scholarly journals The Trend of the Distribution of Ectopic Pregnancy Sites and the Clinical Characteristics of Cesarean Scar Pregnancy

2021 ◽  
Author(s):  
Panpan Tang ◽  
Xiaomao Li ◽  
Wenwei Li ◽  
Yunhui Li ◽  
Yu Zhang ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Cesarean Delivery ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Cesarean Scar Pregnancy ◽  
Variation Trend ◽  
Cesarean Scar ◽  
Increasing Trend ◽  
Common Sign ◽  
Cesarean Delivery Rate

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.

scholarly journals Cesarean Scar Ectopic Pregnancy: Case Report and Review of the Literature

2016 ◽  
Vol 8 (1) ◽  
pp. 66-68
Author(s):  
Thankam Varma ◽  
Shashidhar Boraiah
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
Review Of The Literature ◽  
Artery Embolization ◽  
Cesarean Scar Pregnancy ◽  
Rare Type ◽  
Cesarean Scar ◽  
Maternal Morbidity And Mortality ◽  
Tertiary Care Hospitals

ABSTRACT Cesarean scar ectopic pregnancy is becoming increasingly common in tertiary care hospitals. Cesarean scar pregnancy is a rare type of ectopic pregnancy associated with complications, such as uterine rupture, uncontrollable bleeding which may lead to hysterectomy and increased maternal morbidity and mortality and subsequent infertility. Options available for treatment, such as dilatation and curettage, excision of trophoblastic tissues using laparotomy or laparoscopy, systemically administered methotrexate, and more recently uterine artery embolization. We report two such cases between 2012 and 2013 managed conservatively. How to cite this article Boraiah S, Varma T, Shankar K. Cesarean Scar Ectopic Pregnancy: Case Report and Review of the Literature. J South Asian Feder Obst Gynae 2016;8(1):66-68.

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
Keyword(s):  
Clinical Characteristics ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar

scholarly journals Cesarean Scar Ectopic Pregnancy: The Lurking Danger in Post Cesarean Failed Medical Abortion

2020 ◽  
Author(s):  
Monika Anant ◽  
Anita Paswan ◽  
Chandrajyoti Chandrajyoti
Keyword(s):  
Cesarean Section ◽  
Ectopic Pregnancy ◽  
Medical Abortion ◽  
Accurate Diagnosis ◽  
Tertiary Level ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Life Threatening ◽  
Missed Diagnosis ◽  
Level Hospital

Cesarean scar pregnancy (CSP) is a potentially life threatening ectopic pregnancy where a missed diagnosis is commoner than an accurate diagnosis. Incidence of Ectopic pregnancy is 1 – 2 % and cesarean scar ectopic occurs in about (0.05%) 1 in 2000 of all pregnancies. With increasing cesarean section rates worldwide, CSP is bound to increase with its dreaded complications like uterine rupture and catastrophic hemorrhage. Three patients misdiagnosed as incomplete miscarriages in post cesarean pregnancies in other centers were found to be CSP in Gynaecology department of a tertiary level hospital. All three patients were managed successfully, two surgically and one medically.  

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

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.

scholarly journals Cesarean scar pregnancy: clinicians challenge

2017 ◽  
Vol 6 (5) ◽  
pp. 2101
Author(s):  
Priyanka Harshavardhan Vora ◽  
Vandana Bansal
Keyword(s):  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Uterine Cavity ◽  
Cesarean Scar Pregnancy ◽  
Sequential Approach ◽  
Cesarean Scar ◽  
Caesarean Scar

A case of caesarean scar ectopic pregnancy managed diagnosed early on transvaginal ultrasound and managed successfully by sequential approach of methotrexate and hysteroscopic removal preserving the woman’s fertility is discussed below. Ectopic pregnancy i.e. implantation of the blastocyst outside the endometrium of the uterine cavity occurs in 1.9% of reported pregnancies.

scholarly journals Recurrent Cesarean Scar Ectopic Pregnancy Treated with Systemic Methotrexate

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
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.

scholarly journals Cesarean scar pregnancy: an upcoming challenge

2018 ◽  
Vol 7 (6) ◽  
pp. 2226
Author(s):  
Sunil K. Juneja ◽  
Pooja Tandon ◽  
Bhanupriya .
Keyword(s):  
Ectopic Pregnancy ◽  
Successful Outcome ◽  
Cesarean Scar Pregnancy ◽  
Excessive Bleeding ◽  
Dose Administration ◽  
Cesarean Scar ◽  
Cesarean Deliveries ◽  
Beta Hcg ◽  
Life Threatening ◽  
Previous Cesarean

Background: Cesarean scar pregnancy (CSP) is a type of ectopic pregnancy implanted in the myometrium at the site of previous cesarean scar. Incidence of cesarean deliveries are increasing globally, leading to rise in incidence of cesarean scar pregnancy. Caesarean scar pregnancies are associated with some life-threatening complications such as scar rupture, haemorrhage, disseminated intravascular coagulation, requiring lifesaving hysterectomy. We present our experience with 11 patients with cesarean scar pregnancy, diagnosed using transvaginal colour doppler ultrasound during 3-year period and treated conservatively to preserve the uterus with successful outcome in all patients.Methods: This was a retrospective study, conducted in the Department of Obstetrics and Gynecology of DMC&H, Ludhiana from January 2015 to December 2017. Out of total deliveries (4278), 3.9% (171/4278) were diagnosed as ectopic pregnancy. 6.43% (11/171) of them were diagnosed as cesarean scar ectopic pregnancy. After counseling, all patients underwent conservative management. Injection methotrexate 50mg was administered intramuscularly and beta- HCG was monitored after 4 days and then weekly till it was <1.Results: 2 patients had an increase in beta HCG levels on day 7 and required second dose of methotraxate. 8 patients required blood transfusion due to excessive bleeding on admission. In 9 patients beta HCG levels reduced to <1 in 7 weeks post first methotraxate dose administration, and in remaining 3 it returned to <1 after 8 weeks . No patient required any surgical intervention.Conclusions: Cesarean scar pregnancy, a type of ectopic pregnancy can be safely managed conservatively if diagnosed early.

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