EP40.11: An overview of Caesarean scar pregnancy

Abstract

The aim of the study is to evaluate various diagnostic tools (US in particular) and to analyse methods of effective CSP treatment. Medline, Embase, Cochrane, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were systematically searched for published studies in human subjects (last search 25 January 2022), supplemented by manual searches. One of the classical and the first methods used in these cases is uterine curettage with secondary intrauterine insertion of a Foley catheter (17,18,19). The Foley catheter, as an effective method of hemostasis, is also used in combination with MTX, both systemic and local, with a subsequent puncture and suction of the CSP under US guidance (19). CSP was most often treated with systemic MTX, uterine artery embolisation (UAE)(20,21) dilatation and curettage (D&C), hysterotomy and hysteroscopy. These methods were used in 33.9%, 21.9%, 14.1%, 10.6% and 6.7% of CSP cases, respectively (18, 19). Combined treatment methods were applied more rarely (22, 23, 24). Early diagnosis and treatment offer much better prognosis (12,17). When making a decision about the management in CSP, the following must be considered: size of pregnancy, presence or absence of uterine continuity, β-hCG level, wish to remain fertile and patient's hemodynamic state.