Caesarean scar pregnancy: a review of management options

Curr Opin Obstet Gynecol. 2011 Dec;23(6):415-21. doi: 10.1097/GCO.0b013e32834cef0c.

Abstract

Purpose of review: The current review aims to provide an overview of the already available and emerging treatment modalities for caesarean scar pregnancy (CSP).

Recent findings: CSP is a type of ectopic gestation associated with a high risk of serious complications. The cause of this condition and the best management are still unclear. However, some medical and surgical treatment modalities have been suggested. The main objectives in the clinical management of CSP should be the prevention of massive blood loss and the conservation of the uterus to maintain further fertility, women's health and quality of life. Current data suggest that expectant management should not be recommended, whereas there are accumulating data suggesting that early diagnosis offers single or combined medical and surgical treatment options avoiding uterine rupture and haemorrhage, thus preserving the uterus and fertility.

Summary: No universal treatment guidelines for the management of CSP have been published up to now. The lack of data on the best evidence should encourage any individual case report and further multicentre studies for recommendations establishment.

Publication types

  • Review

MeSH terms

  • Abortifacient Agents, Nonsteroidal / therapeutic use*
  • Abortion, Therapeutic*
  • Cesarean Section / adverse effects*
  • Cicatrix / complications*
  • Counseling
  • Female
  • Fertility
  • Humans
  • Hysteroscopy
  • Methotrexate / therapeutic use*
  • Pregnancy
  • Pregnancy, Ectopic / etiology*
  • Prenatal Care / methods
  • Quality of Life
  • Ultrasonography, Prenatal

Substances

  • Abortifacient Agents, Nonsteroidal
  • Methotrexate