Objective: To evaluate the diagnosis and management modalities of cesarean scar pregnancy according to our experience.
Design And Setting: Retrospective study at the Women's Health Research and Education Hospital.
Patients: Six patients were diagnosed and treated for cesarean scar pregnancy (CSP) with dilatation and curettage, methotrexate (MTX), or laparatomy.
Results: One patient chose the surgical option due to her desire to have a tubal ligation. In the second case methotrexate was applied initially, but two weeks later suction curretage was applied due to abdominal pain and vaginal bleeding. Suction curettage was used as an initial treatment for four patients. There were not any complications in three of four patients. One patient had heavy vaginal bleeding which started after curettage. On ultrasonographic examination, increasing hemorrhage was seen between the uterus and the bladder so subtotal hysterectomy was performed.
Discussion: Ultrasound should be used effectivelly in evaluation of pregnant patients with previous cesarean deliveries. There is still no unique treatment modality for CSP, so treatment should be tailored for each patient. Before the 7th week, abortion should be considered. After the 7th week, MTX and/or surgical options should be preferred.
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BMC Pregnancy Childbirth
January 2025
Department of Gynecology, Shenyang Women's and Children's Hospital, No. 87 Renao Road, Shenyang, Liaoning Province, 110011, China.
Background: This study aimed to investigate the risk factors related to the failure of initial combined local methotrexate (MTX) treatment and minimally invasive surgery for late cesarean scar pregnancy (CSP).
Methods: This retrospective case-control study was conducted between January 2016 and December 2023, involving patients with late CSP (≥ 8 weeks) who received local MTX injection combined with either hysteroscopic or laparoscopic surgery. Cesarean scar pregnancy was classified as type I, II, or III based on the direction of growth of the gestational sac and the residual myometrial thickness as assessed by ultrasound.
Taiwan J Obstet Gynecol
January 2025
Department of Gynecology & Obstetrics, Beijing friendship hospital, Capital Medical University, No. 95, Yong'an Road, Xi-cheng district, Beijing, China. Electronic address:
Objective: To study immediate therapeutic outcomes, subsequent fertility effects and menstrual changes in cesarean scar pregnancy patients who received uterine artery embolization with or without methotrexate followed by ultrasound guided curettage.
Materials And Methods: Totally, 82 patients who met the inclusion criteria were enrolled in our study and divided into two groups. Group I included 50 patients who received uterine artery embolization and ultrasound guided curettage, and Group II had 32 patients who received uterine artery embolization plus methotrexate and ultrasound guided curettage.
J Family Med Prim Care
December 2024
Department of Obstetrics and Gynecology, Society for Health Allied Research and Education, MediCiti Institute of Medical Sciences, Hyderabad, Telangana, India.
Background: A ten-group classification system of caesarean section was proposed by Michael Robson in 2001. It is helpful in comparing the rates of caesarean section between hospitals. The objective of this study was to determine the caesarean section rates to analyse trends of caesarean section and classify according to Robson's categories.
View Article and Find Full Text PDFBiomaterials
January 2025
Translational Medicine Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China; Greater Bay Area Institute of Precision Medicine (Guangzhou), Fudan University, Guangzhou, 511462, China. Electronic address:
Cesarean section (CS) is highly prevalent surgery among females. However, current absorbable anti-adhesion membranes used clinically can partially prevent postoperative adhesions but show limited efficacy in tissue regeneration, leaving post-cesarean women at risk for severe complications including cesarean scar pregnancy, placenta previa, and uterine rupture. Herein, we designed a fully amniotic membrane (AM)-derived biomimetic nanostructural materials (AM-BNMs) as an anti-adhesion barrier, and validated its therapeutic efficacy in a rat CS model.
View Article and Find Full Text PDFInt Urogynecol J
January 2025
Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, No. 128 Jinling Road, Zhanggong District, Ganzhou City, 341000, Jiangxi Province, China.
Introduction And Hypothesis: The relationship between cesarean section scars and active pelvic floor muscle tone lacks sufficient evidence. This study is aimed at investigating the relationship between the severity of cesarean section scars and active pelvic floor muscle tone in postpartum women.
Methods: We conducted a prospective cross-sectional study of 604 women at 6-8 weeks postpartum.
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