Objective: Cesarean scar pregnancy (CSP) is a potentially life-threatening disease that has been steadily increasing in prevalence. Pregnancy termination is usually recommended given the risk of life-threatening complications. In some cases, patients refuse to terminate viable CSPs, even after counseling. Recent studies report that, even with a high burden of possible complications and maternal morbidity, many CSPs progress to live, close to term births. The aim of this study is to further demonstrate the natural history of viable cesarean scar pregnancies.
Methods: We conducted a systematic review of original studies reporting cases of expectant management of CSPs with positive fetal heartbeats.
Results: After selection, 28 studies were included in the review, with a total of 398 cases of CSP, 136 managed expectantly and 117 with positive fetal heartbeat managed expectantly. This study confirmed that the majority of patients experience live births, as 78% of patients selected for expectant management experienced live births at or close to term, with 79% developing morbidly adherent placenta, 55% requiring hysterectomy, and 40% having severe bleeding.
Discussion: The optimal management protocol for CSP is still to be defined and more studies are needed to further elucidate this rare but rising disease. Our study provides information on the natural history of untreated CSPs and suggests that termination may not be the only option offered to the patient.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00404-022-06835-3 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Cost-utility analysis of MR imaging-guided transurethral ultrasound ablation for the treatment of low- to intermediate-risk localised prostate cancer.
BMJ Open
January 2025
Institute of Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
Background: Magnetic resonance-guided transurethral ultrasound ablation (MR-TULSA) is a new focal therapy for treating localised prostate cancer that is associated with fewer adverse effects (AEs) compared with established treatments. To support large-scale clinical implementation, information about cost-effectiveness is required.
Objective: To evaluate the cost-utility of MR-TULSA compared with robot-assisted radical prostatectomy (RARP), external beam radiation therapy (EBRT) and active surveillance (AS) for patients with low- to favourable intermediate-risk localised prostate cancer.
Advancements in Ultrasound Diagnosis of Superficial Endometriosis: Current Challenges and Emerging Techniques.
Gynecol Obstet Invest
January 2025
Background: Endometriosis is a chronic disease characterized by endometrial-like tissue outside the uterus. Superficial endometriosis (SE) is the most prevalent form, yet it remains underdiagnosed due to subtle clinical and imaging presentations. Traditionally, diagnosis relies on laparoscopy, which is relatively invasive and often contributes to diagnostic delay.
View Article and Find Full Text PDFAssessing Malignant Risk in B3 Breast Lesions: Clinical Insights and Implications.
J Clin Med
December 2024
Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
: B3 breast lesions, characterized by uncertain malignant potential, pose a significant challenge for clinicians. With the increasing use of preoperative biopsies, there is a need for careful management strategies, including watchful waiting, vacuum-assisted excision (VAE), and surgery. This study aims to assess the concordance between preoperative biopsy findings and postoperative histology, with a focus on evaluating the positive predictive value (PPV) for malignancy in B3 lesions.
View Article and Find Full Text PDFIdentification of the Determinants of Plexiform Neurofibroma Morbidity in Pediatric and Young Adult Neurofibromatosis Type 1 Patients: A Pilot Multivariate Approach.
Cancers (Basel)
January 2025
Sophia, Department of General Pediatrics, Erasmus MC, 3015 GD Rotterdam, The Netherlands.
Background: Plexiform neurofibromas (PNs) are histologically benign peripheral nerve sheath tumors associated with neurofibromatosis type 1 (NF1) and often lead to significant morbidity due to growth. Management includes watchful waiting, surgery for partial debulking, and, since recently, systemic treatment with MEK inhibitors. However, due to the scarcity of natural history studies, our understanding of the natural progression of PNs to guide clinicians in deciding in whom and when to intervene is scarce.
View Article and Find Full Text PDFAn improvement in visual acuity accompanied by the development of RPE tear: a case report.
BMC Ophthalmol
January 2025
Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
Background: Retinal pigment epithelium (RPE) tear is a well-known complication of RPE detachment and is typically associated with significant visual acuity decline. However, in this case, despite the occurrence of an RPE tear there was an unexpected improvement in visual acuity.
Case Presentation: A 68-year-old male presented with blurred vision in his right eye of a month's duration.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!