Adverse Outcome of Cesarean Scar Pregnancy Managed Expectantly / 中山大学学报(医学科学版)

ABSTRACT

@#：【Objective】Toprovidefurtherevidenceoftheassociationbetweencesareanscarpregnancy（CSP）and placentaincreta，andtoinvestigatetheriskofexpectantmanagementofCSP.【Methods】Aretrospectivereviewof3women diagnosedwithCSP，whoweremanagedexpectantly，wasperformedintheThirdAffiliatedHospitalofSUNYat-sen UniversityfromJanuary2014toDecember2018.Theirclinicalcharacteristics，sonographicmanifestationandpoorout⁃ comeswereanalyzed.【Results】These3casesofCSPhad1~2previouslowersegmentcesareansectionsandtheirclinical symptomsincludedrecurrenthemorrhage，grosshematuriaandsevereabdominalpain.Amongthe3cases，thegestational ageatdiagnosisofCSPwas6+2weeks，7weeksand7+4weeks，respectively；thesonographicCSPtypewastypeⅠ，type ⅡandtypeⅢ，respectively；thegestationalageatthefirstdiagnosisofplacentaincretawas24+4weeks，12+2weeksand 13+1weeks，respectively；andall3caseswerediagnosedasplacentapercretabyultrasoundatthesecondtrimester.These 3casesofCSPwereterminatedatthesecondtrimesterwithoutlivebornneonatesbecauseofseverehemorrhage，colt tamponadeofbladderanduterinerupture；andallwereconfirmedasplacentapercretaduringsurgerywiththetotalblood lossofmorethan2500mLandwithoutmaternaldeath，andonegotapathologicaldiagnosisofplacentapercretaafter subtotal hysterectomy.【Conclusion】Placenta percreta should be noticed during the expectant management of CSP becauseof the close association between CSP and placenta increta. Natural history of CSP is usually associated with adverseoutcome，andthereforeexpectantmanagementofCSPshouldbecarefullychosen