Cesarean Scar Pregnancies Are Dangerous, but Treatment Options Are Many

Cesarean scar pregnancy (CSP) — in which the gestational sac implants within a previous cesarean hysterotomy scar — happens in about 1 in 2000 pregnancies. To explore the diagnosis, treatment, and outcomes of CSP, investigators at one academic institution retrospectively assessed 30 cases spanning 5 years.

Women with CSP presented with pelvic pain or vaginal bleeding or received ultrasonography diagnoses in conjunction with early pregnancy dating. Most CSPs were diagnosed during the first trimester (mean, 46 days) and were managed with methotrexate (maternal intramuscular injection, direct injection into the gestational tissue, or both). Potassium chloride injection into the gestational tissue was used when fetal cardiac activity was present…