Laparoscopic Management of Cesarean Scar Pregnancy

Abstract

With the increase in cesarean deliveries worldwide, the reported incidence of cesarean scar pregnancies (CSPs) has increased [ 1 Timor-Tritsch IE Monteagudo A Unforeseen consequences of the increasing rate of cesarean deliveries: early placenta accreta and cesarean scar pregnancy. A review. Am J Obstet Gynecol. 2012; 207: 14-29 Abstract Full Text Full Text PDF PubMed Scopus (361) Google Scholar , 2 Gonzalez N Tulandi T Cesarean scar pregnancy: a systematic review. J Minim Invasive Gynecol. 2017; 24: 731-738 Abstract Full Text Full Text PDF PubMed Scopus (108) Google Scholar ]. Among conservative interventions, laparoscopic excision and repair may be an effective option, resulting in immediate recovery and remediation of the cesarean scar defect [ 3 Shao MJ Hu MX Hu M Temporary bilateral uterine artery occlusion combined with vasopressin in control of hemorrhage during laparoscopic management of cesarean scar pregnancies. J Minim Invasive Gynecol. 2013; 20: 205-208 Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar , 4 Wang YL Weng SS Huang WC Su TH Laparoscopic management of ectopic pregnancies in unusual locations. Taiwan J Obstet Gynecol. 2014; 53: 466-470 Crossref PubMed Scopus (14) Google Scholar , 5 Jiang S Zhao S Laparoscopic surgery for ectopic pregnancy within a cesarean scar. Clin Exp Obstet Gynecol. 2013; 40: 440-444 PubMed Google Scholar , 6 Wang HY Zhang J Li YN et al. Laparoscopic management of laparoscopy combined with transvaginal management of type II cesarean scar pregnancy. JSLS. 2013; 17: 263-272 Crossref PubMed Scopus (36) Google Scholar , 7 Fuchs N Manoucheri E Verbaan M Einarsson JI Laparoscopic management of extrauterine pregnancy in caesarean section scar: description of a surgical technique and review of the literature. BJOG. 2015; 122: 137-140 Crossref PubMed Scopus (25) Google Scholar , 8 Wang G Liu X Bi F et al. Evaluation of the efficacy of laparoscopic resection for the management of exogenous cesarean scar pregnancy. Fertil Steril. 2014; 101: 1501-1507 Abstract Full Text Full Text PDF PubMed Scopus (54) Google Scholar ]. We retrospectively reviewed the clinical data of 8 women with CSPs treated in a tertiary medical center between October 2006 and October 2017. The mean gestational age at diagnosis was 6.8 weeks, and fetal cardiac activity was identified in 4 cases.