Background: Past history of previous Cesarean delivery [CD] carries the risk for gestational sac implantation of any subsequent pregnancy over the cesarean scar developing what is defined as a cesarean scar pregnancy [CSP]. The aim of this article was to evaluate possible interventions used for the diagnosis and treatment of CSP.
Materials and methods: This cohort analysis of case series included all patients admitted to Obstetrics and Gynecology department, King Faisal Military Hospital over a period of 5 years [2014 through 2019 and evaluated in 2019] with the diagnosis of suspected CSP. Demographic characteristics, clinical and outcome data were obtained from the original electronic hospital charts, operation notes, anesthesia notes, discharge summaries, nursing notes and outpatient medical records.
Results: During the study period 12 patients were diagnosed by US as having CSP, the mean age was 36 years, the mean of parity was 4.7. Most of the patients had previous two CD [33%]. The mean time interval between the previous CD and the current CSP was 16.4 months and the estimated gestational age was 46 days. The mean diameter of the mass in the sac of CSP was 9.7 mm, and the mean of serum β-hCG levels was 53765.8 mIU/mL. All patients were successfully treated by methotrexate and the mean resolution time was 52 days.
Conclusion: Methotrexate [MTX] was effective for treatment of CSP but larger multicenter studies with large number of patients are necessary to confirm our results. |
