Aim: There is currently no universally accepted method for typing of cesarean scar pregnancy (CSP) to guide the choice of treatment approach. We introduce a new method for typing CSP and investigate its clinical significance.
Method: Clinical data of 198 patients with CSP were collected and analyzed. The patients were divided into three types according to the size of their cesarean scar diverticula (CSD), measured by magnetic resonance imaging: type I (size of CSD ≤40 mm), type II (40 mm < size of CSD ≤70 mm) and type III (size of CSD >70 mm).
Results: With increase in the type level, the risk of adverse events increased significantly (χ = 36.345, P = 0.000). There was a significant difference in the choice of the treatment approaches in various types of the patients (χ = 27.106, P = 0.000). With increase in the type level, the invasiveness level of the treatment approach increased significantly (R = 0.405, P = 0.000). Further analysis found two other factors that influenced treatment choice.
Conclusion: Our study, for the first time, demonstrates the value of size of CSD in typing of CSP and, thereby supplements the CSP typing system with a novel quantitative indicator. This typing method is of significance for evaluation of risk of CSP and guiding the choice of treatment approach. This typing method, combined with the two features of cesarean scar thickness and lesions protruding outside the uterine contour, will improve the risk assessment of CSP and the rationale of treatment plan formulation for this condition.
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http://dx.doi.org/10.1111/jog.14226 | DOI Listing |
Postgrad Med J
December 2024
Department of Obstetrics and Gynecology, Vienna University Hospital/Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
Background: On the second day of my clinical observership in the Obgyn Department of the Vienna University Hospital, I saw a suspected case of caesarean scar pregnancy on follow-up, with one of my very senior professors, in the gynaecology outpatient clinic.
Methods: The 29-year-old multigravida with a previous caesarean section had earlier presented to the emergency room with vaginal bleeding at 7 weeks of gestation.
Results: Ultrasound scan revealed a non-viable low-lying gestational sac located near the caesarean section scar, with a myometrial thickness of 0.
PLoS One
December 2024
Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.
Background: Caesarean section (CS) is the most common inpatient surgical procedure performed in Canada. CS is known to cause moderate-to-severe pain, which is suggested to be associated with postpartum depression and persistent pain. Existing limitations in multimodal analgesia and conscious attempts to avoid opioids highlight the need for non-pharmacological strategies.
View Article and Find Full Text PDFJ Ultrason
December 2024
Department of Obstetrics and Gynecology, Necmettin Erbakan Univercity, Meram School of Medicine, Konya, Turkey.
Aim: This study aimed to evaluate the effects of diabetes mellitus and cervical dilatation on cesarean section scar healing.
Material And Methods: This prospective study included pregnant women diagnosed with diabetes mellitus and healthy control pregnant women. The study group was divided into active labor and pre-active labor based on cervical dilatation, and the diabetic group was categorized into gestational diabetes and preexisting diabetes mellitus.
Case Rep Womens Health
December 2024
Médecins Sans Frontières-Belgique (OCB), Avenue 7 Février, Grande passe, Port-à-Piment, Haïti.
Uterine rupture is a well-known, life-threatening complication of misoprostol use; the incidence is remarkably low. Herein, we report what seems to be the first documented case of uterine rupture following induction of labour for intrauterine foetal death in the second trimester without a uterine scar. A 40-year-old woman with no history of caesarean section or uterine surgery presented with mild lower abdominal pain and mild genital bleeding.
View Article and Find Full Text PDFEur J Obstet Gynecol Reprod Biol
December 2024
Department of Obstetrics & Gynaecology, Jawaharlal Institute of Medical Education & Research, Puducherry 605006, India. Electronic address:
Objective: To develop and internally validate a model predicting successful trial of labour among pregnant women with previous caesarean scar.
Design: Cohort study.
Setting: Tertiary care and teaching hospital.
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