L K Wei1, L M Yu, R M Mu, F X Xue. 1. Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin 300052, China.
Abstract
Objective: To investigate the reproductive outcomes after the previous cesarean scar pregnancy (CSP). Methods: The clinical data of 138 patients with CSP in Tianjin Medical University General Hospital from January 2011 to March 2016 were collected and analyzed.Fifty-four cases underwent uterine artery embolization+ dilation & curettage (UAE+ D&C) surgery, 41 cases underwent D&C surgery, and 43 cases underwent laparoscopic surgery.Reproductive outcomes were followed up and analyzed. Results: All women were followed up for (46±17) months.It was encouraging that 37 women got 42 spontaneous pregnancies among 50 women with fertility plan, and the subsequent spontaneous pregnancy rate was 74.0%(37/50). Unfortunately, 6 women experienced recurrence of CSP (RCSP) in the subsequent pregnancies, and the RCSP rate was 14.3%(6/42). There were no significant differences with regard to spontaneous pregnancy rate and RCSP rate among the 3 groups (P>0.05). Nineteen women had led to a live delivery indeed without the presence of placenta previa, placenta accrete, uterine rupture and postpartum hemorrhage in the perinatal period. Conclusion: The reproductive outcomes following the previous CSP include the intrauterine pregnancy, spontaneous abortion and RCSP.The individualized treatments on CSP had no significant differences to the subsequent spontaneous pregnancy rate which was favorable in the future fertility plan.The incidence of RCSP was not significantly reduced by laparoscopic uterine scar repair.The risk of RCSP appeared to be increased in the subsequent pregnancies, and early diagnosis and treatment were needed to exclude the abnormal CSP.The overall perinatal outcomes were favorable.
Objective: To investigate the reproductive outcomes after the previous cesarean scar pregnancy (CSP). Methods: The clinical data of 138 patients with CSP in Tianjin Medical University General Hospital from January 2011 to March 2016 were collected and analyzed.Fifty-four cases underwent uterine artery embolization+ dilation & curettage (UAE+ D&C) surgery, 41 cases underwent D&C surgery, and 43 cases underwent laparoscopic surgery.Reproductive outcomes were followed up and analyzed. Results: All women were followed up for (46±17) months.It was encouraging that 37 women got 42 spontaneous pregnancies among 50 women with fertility plan, and the subsequent spontaneous pregnancy rate was 74.0%(37/50). Unfortunately, 6 women experienced recurrence of CSP (RCSP) in the subsequent pregnancies, and the RCSP rate was 14.3%(6/42). There were no significant differences with regard to spontaneous pregnancy rate and RCSP rate among the 3 groups (P>0.05). Nineteen women had led to a live delivery indeed without the presence of placenta previa, placenta accrete, uterine rupture and postpartum hemorrhage in the perinatal period. Conclusion: The reproductive outcomes following the previous CSP include the intrauterine pregnancy, spontaneous abortion and RCSP.The individualized treatments on CSP had no significant differences to the subsequent spontaneous pregnancy rate which was favorable in the future fertility plan.The incidence of RCSP was not significantly reduced by laparoscopic uterine scar repair.The risk of RCSP appeared to be increased in the subsequent pregnancies, and early diagnosis and treatment were needed to exclude the abnormal CSP.The overall perinatal outcomes were favorable.