Primary evacuation therapy for Cesarean scar pregnancy: three new cases and review

• Published in: Ultrasound in obstetrics & gynecology 2006-02, Vol.27 (2), p.222-226
• Main Authors: Wang, C.‐B., Tseng, C.‐J.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Cesarean scar pregnancy; Cesarean Section - adverse effects; Cicatrix - complications; deep implantation; Female; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Postoperative Complications - etiology; Pregnancy; Pregnancy, Ectopic - etiology; Pregnancy, Ectopic - surgery; primary evacuation treatment; transvaginal sonography; Uterine Hemorrhage - etiology; Uterine Rupture - etiology
• ISSN: 0960-7692; 1469-0705
• DOI: 10.1002/uog.2644

We report three cases of first‐trimester Cesarean scar pregnancy (CSP) treated with evacuation therapy. In one patient with a gestational age of 7 weeks and with deep sac implantation, there was massive uterine bleeding and uterine perforation following evacuation. The other two patients, both with a pregnancy < 7 weeks and with intrauterine gestational sacs, were successfully treated with surgical evacuation without complications. A MEDLINE search revealed 11 cases that fulfilled our criteria of a certain diagnosis of scar pregnancy and with evacuation as the primary treatment. The outcome of these 11 cases and that of our three new cases suggests that the combination of a gestational sac size corresponding to a gestational age ≥ 7 weeks, coupled with a deep implantation, portend an unsatisfactory outcome of surgical evacuation as a means of treating CSP. Copyright © 2005 ISUOG. Published by John Wiley & Sons, Ltd.