Subsequent pregnancy outcome after conservative treatment of a previous cesarean scar pregnancy

Kok Min Seow, Jiann Loung Hwang, Yieh Loong Tsai, Lee Wen Huang, Yu Hung Lin, Bin Chwen Hsieh

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Background. To assess pregnancy course and outcome after conservative treatment of a cesarean scar pregnancy. Methods. During an 8-year period, 15 cases of cesarean scar pregnancies were diagnosed at our institution. Seven of the 14 patients for whom we successfully preserved the uterus; became pregnant within 3 years after termination of the scar pregnancy. The year of diagnosis, conservative method and gestational age for these five patients were recorded. Delivery method, time interval between the scar pregnancy and subsequent pregnancy, and maternal and neonatal outcome were evaluated. Results. Seven pregnancies (eight live and one dead baby) were noted. The mean interval between the ectopic pregnancy and subsequent pregnancy was 13.3 months (range 0-34 months). One patient, who became pregnant 3 months after the scar pregnancy was found, suffered uterine rupture at 38.3 weeks' gestational age. Two patients with placental accrete, and one of them who continued the existing intrauterine twin pregnancy after transvaginal sono-guided aspiration of the scar pregnancy received a cesarean hysterectomy at 32 weeks of gestation. The remaining four pregnancies were uneventful, followed by early cesarean sections at 36 weeks. Conclusion. The results of this first series of seven subsequent pregnancies after conservative treatment of scar pregnancies are promising. An early cesarean section before over-extension of the uterus and spontaneous labor can help to prevent uterine rupture. Placenta accrete is another severe morbidity of these patients in addition to uterine rupture. Thus a cesarean hysterectomy may be the choice of treatment.

Original languageEnglish
Pages (from-to)1167-1172
Number of pages6
JournalActa Obstetricia et Gynecologica Scandinavica
Volume83
Issue number12
DOIs
Publication statusPublished - Dec 2004

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Pregnancy Outcome
Cicatrix
Pregnancy
Uterine Rupture
Hysterectomy
Cesarean Section
Conservative Treatment
Gestational Age
Uterus
Twin Pregnancy
Ectopic Pregnancy
Placenta
Mothers

Keywords

  • Cesarean hysterectomy, cesarean scar pregnancy
  • Placenta accrete
  • Uterine rupture

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Subsequent pregnancy outcome after conservative treatment of a previous cesarean scar pregnancy. / Seow, Kok Min; Hwang, Jiann Loung; Tsai, Yieh Loong; Huang, Lee Wen; Lin, Yu Hung; Hsieh, Bin Chwen.

In: Acta Obstetricia et Gynecologica Scandinavica, Vol. 83, No. 12, 12.2004, p. 1167-1172.

Research output: Contribution to journalArticle

Seow, Kok Min ; Hwang, Jiann Loung ; Tsai, Yieh Loong ; Huang, Lee Wen ; Lin, Yu Hung ; Hsieh, Bin Chwen. / Subsequent pregnancy outcome after conservative treatment of a previous cesarean scar pregnancy. In: Acta Obstetricia et Gynecologica Scandinavica. 2004 ; Vol. 83, No. 12. pp. 1167-1172.
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