Fertility performance and obstetric outcomes among women with previous cesarean scar pregnancy

J Ultrasound Med. 2011 Sep;30(9):1179-84. doi: 10.7863/jum.2011.30.9.1179.

Abstract

Objectives: The purpose of this study was to assess fertility performance and obstetric outcomes after treatment of cesarean scar pregnancy.

Methods: We conducted a retrospective study in a large tertiary hospital in Israel. The study included 18 women with a diagnosis of cesarean scar pregnancy between 2000 and 2009.

Results: The incidence of cesarean scar pregnancy among our parturient patients was 1 per 3000 for the general obstetric population and 1 per 531 among those with at least 1 cesarean delivery. Sixteen were treated primarily with methotrexate. Two were treated primarily by surgery, and 2 more were treated by surgery after failed methotrexate treatment. After cesarean scar pregnancy treatment, 7 women conceived spontaneously, and 1 conceived by in vitro fertilization-intracytoplasmic sperm injection. The remaining 10 (55%) did not wish to conceive again. Two of the women who became pregnant (25%) had recurrent cesarean scar pregnancy.

Conclusions: This study shows encouraging results for fertility performance and obstetric outcomes after treatment of cesarean scar pregnancy. Nevertheless, the risk of recurrent cesarean scar pregnancy is not negligible.

MeSH terms

  • Abortifacient Agents, Nonsteroidal
  • Abortion, Induced / methods
  • Adult
  • Cesarean Section / adverse effects*
  • Cicatrix / complications*
  • Female
  • Humans
  • Incidence
  • Infertility, Female / epidemiology
  • Infertility, Female / etiology
  • Israel / epidemiology
  • Methotrexate
  • Pregnancy
  • Pregnancy Complications / diagnostic imaging*
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / therapy*
  • Pregnancy Outcome
  • Pregnancy, Ectopic / diagnostic imaging*
  • Pregnancy, Ectopic / epidemiology
  • Pregnancy, Ectopic / etiology
  • Pregnancy, Ectopic / therapy*
  • Retrospective Studies
  • Ultrasonography, Interventional / methods
  • Ultrasonography, Prenatal*

Substances

  • Abortifacient Agents, Nonsteroidal
  • Methotrexate