Progress in Treatment of Cesarean Scar Pregnancy

Asiyan Nusilati; LIN Kai-qing; XU Kai-hong

Abstract：Cesarean scar pregnancy (CSP) is a very rare form of ectopic pregnancy and one of the long-term complications of cesarean section. A delay in diagnose or misdiagnose can lead to excessive hemorrhage, hemorrhagic shock , uterine rupture and may endanger the patient′s life. The pathogenesis of CSP is unknown and there is currently no consensus on the treatment. Simple methotrexate treatment has a high risk of hemorrhage, but it can be an adjuvant therapy for surgical treatment. Uterine curettage is a less invasive treatment, but it can also lead to a massive bleeding if you don′t know the indications well. Preoperative uterine artery embolization can reduce the bleeding, but it has many adverse reactions and it′s high priced. Given the lack of the sufficient evidence on the outcome of hysteroscopic, laparoscopic, these interventions should be applied in a research setting with long-term follow-up. Although transabdominal or tansvaginal local lesion resection with repair can treat the disease and remove the old scar, it is more invasive and should be the supplementary treatment of the precious treatments only. The first line treatment still needs a large number of study and research, therefore, the management plan should be individually tailored.