Korean J Obstet Gynecol.  2004 Nov;47(11):2189-2193.

Diagnosis and Management of Pregnancies Implanted into the Lower Uterine Segment Cesarean Section Scar

• Lee CH
• Ku SJ
• Kim SB
• Kim JH
• Kim HJ

Abstract

OBJECTIVE
To describe diagnosis and management of Cesarean section scar pregnancy increased at recently due to high Cesarean section rate.
METHODS
Eleven cases of pregnancies implanted into the lower uterine segment Cesarean section scar were diagnosed and treated at Daegu Fatima hospital during January 1999 to May 2004. All cases are confirmed by transvaginal ultrasound scan. The management of Cesarean section scar pregnancies included transvaginal evacuation, hysterotomy and medical treatment with methotrexate systemic or local injection into gestational sac.
RESULTS
Eleven Cesarean section scar pregnancies were diagnosed. Medical treatment was used in nine women and four women was successful. The success rate were 44% (4/9). Surgical treatment was used in two women included transvaginal evacuation and hysterotomy. Seven women (63%) required blood transfusion and one women (9%) had a hysterectomy.
CONCLUSION
Cesarean section scar pregnancies are more common. When the diagnosis is made in early pregnancy the prognosis is good and prevent late pregnancy complication include placenta previa, placental accreta and uterine rupture. The risk of hystrectomy is relatively low.

Keyword

Cesarean section scar; Ultrasound; Early pregnancy; Ectopic pregnancy

MeSH Terms

Blood Transfusion
Cesarean Section*
Cicatrix*
Daegu
Diagnosis*
Female
Gestational Sac
Humans
Hysterectomy
Hysterotomy
Methotrexate
Placenta Previa
Pregnancy Complications
Pregnancy*
Pregnancy, Ectopic
Prognosis
Ultrasonography
Uterine Rupture
Methotrexate