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Cesarean Scar Pregnancy Successfully Managed to Term: When the Patient Is Determined to Keep the Pregnancy

Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy, defined as the implantation of the gestational sac at the uterine incision scar of the previous cesarean section. This condition is associated with severe maternal and fetal/neonatal complications, including severe bleeding, rupture...

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Autores principales: Kutlesic, Ranko, Kutlesic, Marija, Vukomanovic, Predrag, Stefanovic, Milan, Mostic-Stanisic, Danka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7598584/
https://www.ncbi.nlm.nih.gov/pubmed/32987706
http://dx.doi.org/10.3390/medicina56100496
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author Kutlesic, Ranko
Kutlesic, Marija
Vukomanovic, Predrag
Stefanovic, Milan
Mostic-Stanisic, Danka
author_facet Kutlesic, Ranko
Kutlesic, Marija
Vukomanovic, Predrag
Stefanovic, Milan
Mostic-Stanisic, Danka
author_sort Kutlesic, Ranko
collection PubMed
description Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy, defined as the implantation of the gestational sac at the uterine incision scar of the previous cesarean section. This condition is associated with severe maternal and fetal/neonatal complications, including severe bleeding, rupture of the uterus, fetal demise, or preterm delivery. In view of these, early diagnosis allows the option of termination of pregnancy. In this case report, we present a patient with a cesarean scar pregnancy who was diagnosed at the sixth week of gestation but declined early termination of the pregnancy and was managed to the 38th week. Placenta previa was confirmed in the second trimester. A planned cesarean section was performed that resulted in the birth of a live full-term neonate. Intraoperatively, placenta percreta was diagnosed, and due to uncontrollable bleeding, a hysterectomy was performed. The postoperative course was uneventful. In cases where an early diagnosis of CSP is made, women should be counseled that this will almost certainly evolve to placenta previa, and the associated risks should be explained. Close follow-up of CSP is mandatory if expectant management is selected. Further studies are needed for definitive conclusions and to determine the risks of expectant management.
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spelling pubmed-75985842020-10-31 Cesarean Scar Pregnancy Successfully Managed to Term: When the Patient Is Determined to Keep the Pregnancy Kutlesic, Ranko Kutlesic, Marija Vukomanovic, Predrag Stefanovic, Milan Mostic-Stanisic, Danka Medicina (Kaunas) Case Report Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy, defined as the implantation of the gestational sac at the uterine incision scar of the previous cesarean section. This condition is associated with severe maternal and fetal/neonatal complications, including severe bleeding, rupture of the uterus, fetal demise, or preterm delivery. In view of these, early diagnosis allows the option of termination of pregnancy. In this case report, we present a patient with a cesarean scar pregnancy who was diagnosed at the sixth week of gestation but declined early termination of the pregnancy and was managed to the 38th week. Placenta previa was confirmed in the second trimester. A planned cesarean section was performed that resulted in the birth of a live full-term neonate. Intraoperatively, placenta percreta was diagnosed, and due to uncontrollable bleeding, a hysterectomy was performed. The postoperative course was uneventful. In cases where an early diagnosis of CSP is made, women should be counseled that this will almost certainly evolve to placenta previa, and the associated risks should be explained. Close follow-up of CSP is mandatory if expectant management is selected. Further studies are needed for definitive conclusions and to determine the risks of expectant management. MDPI 2020-09-24 /pmc/articles/PMC7598584/ /pubmed/32987706 http://dx.doi.org/10.3390/medicina56100496 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Kutlesic, Ranko
Kutlesic, Marija
Vukomanovic, Predrag
Stefanovic, Milan
Mostic-Stanisic, Danka
Cesarean Scar Pregnancy Successfully Managed to Term: When the Patient Is Determined to Keep the Pregnancy
title Cesarean Scar Pregnancy Successfully Managed to Term: When the Patient Is Determined to Keep the Pregnancy
title_full Cesarean Scar Pregnancy Successfully Managed to Term: When the Patient Is Determined to Keep the Pregnancy
title_fullStr Cesarean Scar Pregnancy Successfully Managed to Term: When the Patient Is Determined to Keep the Pregnancy
title_full_unstemmed Cesarean Scar Pregnancy Successfully Managed to Term: When the Patient Is Determined to Keep the Pregnancy
title_short Cesarean Scar Pregnancy Successfully Managed to Term: When the Patient Is Determined to Keep the Pregnancy
title_sort cesarean scar pregnancy successfully managed to term: when the patient is determined to keep the pregnancy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7598584/
https://www.ncbi.nlm.nih.gov/pubmed/32987706
http://dx.doi.org/10.3390/medicina56100496
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