Outcome of cesarean scar pregnancies diagnosed sonographically in the first trimester

Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
Aya Y MichaelsDaniela A Carusi

Abstract

The purpose of this study was to determine the outcome of cesarean scar pregnancies diagnosed during the first trimester. We retrospectively identified all cesarean scar implantation pregnancies diagnosed by sonography before 14 weeks' gestation between 2000 and 2012 at our institution. We reviewed the patients' sonograms and medical records and recorded sonographic findings and pregnancy outcomes. Thirty-four cases met study entry criteria. Ten patients presented with no embryonic cardiac activity, of whom 7 underwent interventions, and 3 were expectantly managed. One of the former 7 and none of the latter 3 required hysterectomy for bleeding. Among the 24 patients with embryonic cardiac activity, 8 were managed expectantly: 5 (62.5%) ultimately delivered a live-born neonate, 3 (60.0%) of whom required hysterectomy due to placenta accreta; and 3 had fetal demise. Sixteen of the 24 underwent interventions, 2 opting for gravid hysterectomy (10 and 11 weeks' gestation, respectively) and 14 treated by a minimally invasive method: intrasac potassium chloride injection (3 cases); intrasac potassium chloride injection plus intramuscular methotrexate (4 cases); sonographically guided dilation and curettage (6 cases); and laparascopic ...Continue Reading

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Jan 23, 2016·Fertility and Sterility·Kathrine Birch PetersenHenriette Svarre Nielsen
Jan 15, 2016·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·D JurkovicJ A Ross
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