Cesarean Scar Pregnancies and Reproductive Outcomes: A Single Center Experience
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KünyeDoğru, Ş., Akkuş, F., Altınordu Atcı, A., Eren, G., Acar, A. (2023). Cesarean scar pregnancies and peproductive outcomes: A single center experience. Journal of Clinical Obstetrics and Gynecology, 33, 1, 36-42.
Objective: The rising rate of cesarean delivery increases the occurrence of cesarean scar pregnancies (CSP). Early diagnosis and treatment of CSP have become the subject of considerable interest in recent years because of the risk of life-threatening uterine bleeding and rupture. The aim of this study was to share the results of ultrasonography (USG)-guided dilation and curettage (D&C) and hysterotomy in treating early CSP and the long-term reproductive results in these cases. Material and Methods: Patients diagnosed with CSP admitted to the perinatology clinic between January 2016 and April 2020 were included in this study. USG-guided D&C was recommended for all patients diagnosed with CSP in the first trimester (<= 12 gestational weeks). Hysterotomy was recommended for patients who could not undergo D&C. All patients' demographic data and procedure results were retrieved retrospectively from electronic records, and reproductive anamneses after the procedure were obtained from patient files and telephone calls. Results: Sixty-three patients who underwent USG-guided D&C and hysterotomy were included in the study. While D&C was successful in 93.65% ( n=59) of these patients, 6.35% (n=4) underwent hysterotomy. In the USG-guided D&C group, the infertility rate was 15.78% (n=6), the rate of the recurrent scars was 9.3% (n=3), and the rate of placenta accreta spectrum was 6.25% (n=2). The term healthy pregnancy rate was 64%. Conclusion: In experienced hands, USG-guided D& C can be considered the first choice in early scar pregnancies. We believe that similar reproductive results would be obtained when D&C and other treatment modalities were compared in CSP treatment.