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Cesarean Scar Pregnancy and Morbidly Adherent Placenta: Different or Similar?
Marina Pekar-Zlotin1, Yaakov Melcer1, Orna Levinsohn-Tavor1
1Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Background:
Growing evidence suggests that cesarean scar pregnancy (CSP) and morbidly adherent placenta (MAP) may represent a continuum of the same disease.
Objectives:
To investigate and compare the prior risk factors in women with either CSP or MAP.
Methods:
The study included 33 women diagnosed with CSP in our department between 2006 and 2014. For each CSP case, two pregnant patients with MAP were matched for hospitalization date from delivery ward records, constituting the control group.
Results:
In both groups, maternal age, parity, and previous early and late abortions were similar. The rate of conception by assisted reproductive technologies was 9% in both groups. Although the number of previous cesarean sections was statistically different between CSP versus MAP (2.0 ± 1.0 vs. 1.0 ± 1.0, respectively, P = 0.006), the leading indication of previous cesarean section was breech presentation in both groups (28.1% and 27.8%, respectively, P > 0.05).
Conclusions:
CSP and MAP share similar prior risk factors. Due to high morbidity in both diseases, further research is needed toward reducing the known etiological factors contributing to the growing number of both complications.
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