Journal
BEST PRACTICE & RESEARCH CLINICAL OBSTETRICS & GYNAECOLOGY
Volume 89, Issue -, Pages -Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.bpobgyn.2023.102353
Keywords
Conservative management; Cesarean scar pregnancy; Uterine rupture; Placenta accreta spectrum
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The incidence of Cesarean scar pregnancies (CSPs) is increasing globally and there is considerable variation in the management of this condition. The diagnosis and expectant management of CSP in low-resource settings is lacking. Standardization in reporting different types of CSPs and correlating these with pregnancy outcomes is important for developing guidance for expectant management. © 2023 Published by Elsevier Ltd.
The incidence of Cesarean scar pregnancies (CSPs) is rising globally. Ultrasound criteria for the diagnosis of CSPs have been described by the International Society of Ultrasound in obstetrics and gynecology and appear to be well used in various centers around the world. There is no guidance on best practices for expectant management of CSP, and there is considerable variation in how this is offered globally. Many studies have reported significant maternal morbidity in cases of CSP with fetal cardiac activity managed expectantly, largely relating to hemorrhage and cesarean hysterectomy from placenta accreta spectrum. However, high live birth rates are also reported. Literature describing the diagnosis and expectant management of CSP in low-resource settings is lacking. Expectant management in selected cases where no fetal cardiac activity is present is a reason-able option and can be associated with good maternal outcomes. Standardization in reporting different types of CSPs and correlating these with pregnancy outcomes will be an important next step in developing guidance for expectant management of this high-risk pregnancy with a high burden of complications. & COPY; 2023 Published by Elsevier Ltd.
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