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An updated guide to the diagnosis and management of cesarean scar pregnancies
- Source :
- Current opinion in obstetricsgynecology. 32(4)
- Publication Year :
- 2020
-
Abstract
- Purpose of review To review the current literature on the diagnosis and management of cesarean scar pregnancies RECENT FINDINGS: The incidence of cesarean scar pregnancies (CSPs) is increasing as a result of the increasing cesarean section rate, improved diagnostic capabilities, and a growing awareness. CSPs are associated with significant morbidity and early diagnosis is key. Diagnosis is best achieved with transvaginal ultrasound. Sonographic diagnostic criteria have been developed over decades and recently endorsed by the Society for Maternal-Fetal Medicine and other professional societies. The current categorization system differentiates CSPs that are endogenic or 'on the scar' from those that are exogenic or 'in the niche'. Following diagnosis, the challenge remains in determining the optimal management as multiple modalities can be considered. Studies have demonstrated the favorable outcomes with combined local and systemic methotrexate, surgical excision through multiple routes, and adjunctive therapies, such as uterine artery embolization or uterine balloons. The current evidence is insufficient to identify a single best treatment course and a combined approach to treatment is often required. Summary Successful outcomes while minimizing complications can be achieved with a multidisciplinary, collaborative effort. Guidelines for cesarean scar pregnancies will continue to evolve as the published reports grow.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
MEDLINE
Ultrasonography, Prenatal
Disease course
Dilatation and Curettage
03 medical and health sciences
Cicatrix
0302 clinical medicine
Uterine artery embolization
Pregnancy
medicine
Humans
Multiple modalities
Intensive care medicine
Abortifacient Agents, Nonsteroidal
030219 obstetrics & reproductive medicine
business.industry
Cesarean Section
Obstetrics and Gynecology
Uterine Artery Embolization
Combined Modality Therapy
Optimal management
Combined approach
Pregnancy, Ectopic
Transvaginal ultrasound
Methotrexate
030220 oncology & carcinogenesis
Surgical excision
Female
business
Subjects
Details
- ISSN :
- 1473656X
- Volume :
- 32
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Current opinion in obstetricsgynecology
- Accession number :
- edsair.doi.dedup.....897e85beff4b7f6da44bd8dc30fd28f9