Purpose Of Review: The current review aims to provide an overview of the already available and emerging treatment modalities for caesarean scar pregnancy (CSP).
Recent Findings: CSP is a type of ectopic gestation associated with a high risk of serious complications. The cause of this condition and the best management are still unclear. However, some medical and surgical treatment modalities have been suggested. The main objectives in the clinical management of CSP should be the prevention of massive blood loss and the conservation of the uterus to maintain further fertility, women's health and quality of life. Current data suggest that expectant management should not be recommended, whereas there are accumulating data suggesting that early diagnosis offers single or combined medical and surgical treatment options avoiding uterine rupture and haemorrhage, thus preserving the uterus and fertility.
Summary: No universal treatment guidelines for the management of CSP have been published up to now. The lack of data on the best evidence should encourage any individual case report and further multicentre studies for recommendations establishment.
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http://dx.doi.org/10.1097/GCO.0b013e32834cef0c | DOI Listing |
Am J Obstet Gynecol MFM
January 2025
Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel; Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
Objective: Post-cesarean delivery (CD) acute pain may progress to chronic pain, which may impair maternal bonding and child development. In 2013, we compared the efficacy of versus on-demand oral analgesia for post-caesarean pain in a randomized-controlled-trial. The fixed-time-interval group had received scheduled paracetamol, tramadol, and diclofenac regardless of pain level, and the on-demand group received medication as needed, with oxycodone reserved for unrelieved pain in both groups.
View Article and Find Full Text PDFSci Rep
January 2025
Science and Technology Innovation Center, Shandong Provincial Key Medical and Health Laboratory of Blood Ecology and Biointelligence, Jinan Key Laboratory of Medical Cell Bioengineering, Cardio- cerebrovascular Disease Hospital of Jinan, The Fourth People's Hospital of Jinan, The Teaching Hospital of Shandong Second Medical University, 50 Shifan Road, Tianqiao District, Jinan, 250031, Shandong, China.
Previous cesarean scar defect (PCSD), also acknowledged as the myometrium of uterus defects, which commonly results in myometrial discontinuity between the uterine and cervical cavity. Current literatures have indicated the efficacy of MSCs and MSC-derived exosomes (MSC-Exos) for diverse refractory disease administration, yet the feasibility of MSC-Exos for PCSD treatment is largely obscure. In this study, we took advantage of the in vivo myofibrotic model for mimicking the typical manifestation of PCSD and the assessment of fertility.
View Article and Find Full Text PDFCureus
November 2024
Department of Fetal Medicine, Amrita Institute of Medical Sciences and Research Centre, Faridabad, IND.
Cesarean scar ectopic pregnancy (CSEP) is localized over the scar of a previous cesarean section. CSEP is a challenging entity, both in terms of diagnosis and management. The clinical presentation of CSEP may vary from asymptomatic patients with positive urine pregnancy tests to acute presentations such as pelvic pain, bleeding per vaginum, uterine rupture, and hemodynamic instability.
View Article and Find Full Text PDFBackground Uterine isthmocele, a defect in the uterine wall at the cesarean scar, is increasingly recognized due to the rising rate of cesarean deliveries. Often asymptomatic, it may lead to complications such as abnormal bleeding, chronic pelvic pain, secondary infertility, or uterine rupture during subsequent pregnancies. Objective This study aimed to assess the prevalence, clinical features, and associated risk factors of uterine isthmocele among women with previous cesarean scars over four years (2019-2023) at Rabia Balkhi Hospital, Afghanistan.
View Article and Find Full Text PDFTurk J Med Sci
December 2024
Department of Obstetrics and Gynecology, Faculty of Medicine, Gazi University, Ankara, Turkiye.
Background/aim: Cesarean section (CS) is a widely performed operation worldwide but data about uterine closure are lacking. We aimed to evaluate scar niches and compare single-layer and double-layer uterine closure at 6 months following CS.
Materials And Methods: This prospective randomized trial assessed 56 women undergoing single- or double-layer uterine closure.
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