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Caesarean scar pregnancy: a 10-year experience
Jennifer K Y Ko1, Raymond H W Li, Vincent Y T Cheung
1Department of Obstetrics and Gynecology, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China.
Aims:
To review the management and outcome of all women with caesarean scar pregnancy (CSP) at a single centre.
Methods:
A retrospective review of women diagnosed with CSP between January 2004 and December 2013 was performed. Women were identified from the admission and Early Pregnancy Assessment Clinic records.
Results:
Twenty-two cases of CSP were identified during the study period. The median gestational age at diagnosis was 6.7 weeks (range 4.7-11.8 weeks). All diagnoses were made by ultrasound, the most common finding of which was a heterogeneous mass at the site of the caesarean scar (100%). The median duration for human chorionic gonadotropin to return to undetectable level was 10 weeks (range 2-20 weeks), although the duration for sonographic resolution of the CSP can take much longer. The success rate of intralesional methotrexate was 80% in our series.
Conclusion:
There is no consensus regarding the method of choice for managing CSP. Medical management using intralesional methotrexate appears to be an acceptable treatment in clinically stable women.
