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Nonsuction Compared With Suction Dilation and Curettage Management of Cesarean Scar Ectopic Pregnancy
Jennifer E Kaiser1, Susan Nourse1, Savvy Benipal1
1ASCENT Center for Reproductive Health and the Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah; and the Department of General Surgery, Oregon Health & Science University, Portland, Oregon.
Objective:
To compare complication rates between suction dilation and curettage (D&C) and nonsuction management of cesarean scar ectopic pregnancy.
Methods:
We performed a single-center, retrospective chart review of cesarean scar ectopic pregnancy management from January 2008 to March 2025. Nonsuction management included medical and other surgical treatments. Our primary outcome was a 10-item complication composite. Secondary outcomes included complication rates associated with misdiagnosis and a gestational age subanalysis. We compared outcomes using χ2 tests.
Results:
We included 77 patients with cesarean scar ectopic pregnancies. Forty-four (57.1%) underwent nonsuction management, and 33 (42.9%) underwent suction D&C. Complication rates were higher for nonsuction management compared with suction D&C (17/44 [38.6%] vs 5/33 [15.2%], respectively; risk ratio (RR) 2.6, 95% CI, 1.0-6.2). Initial misdiagnosis of cesarean scar ectopic pregnancy was associated with higher complication rates (11/22 [50.0%]; RR 2.5, 95% CI, 1.3-4.9).
Conclusion:
Nonsuction management resulted in 2.5 times more complications than suction D&C for cesarean scar ectopic pregnancy.
