title: Primary evacuation therapy for Cesarean scar pregnancy: three new cases and review.
abstract: We report three cases of first-trimester Cesarean scar pregnancy (CSP) treated with evacuation therapy. In one patient with a gestational age of 7 weeks and with deep sac implantation, there was massive uterine bleeding and uterine perforation following evacuation. The other two patients, both with a pregnancy < 7 weeks and with intrauterine gestational sacs, were successfully treated with surgical evacuation without complications. A MEDLINE search revealed 11 cases that fulfilled our criteria of a certain diagnosis of scar pregnancy and with evacuation as the primary treatment. The outcome of these 11 cases and that of our three new cases suggests that the combination of a gestational sac size corresponding to a gestational age >/= 7 weeks, coupled with a deep implantation, portend an unsatisfactory outcome of surgical evacuation as a means of treating CSP.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chia Yi, Taiwan, ROC.
authors.forename: C-B
authors.initials: CB
authors.lastname: Wang
authors.forename: C-J
authors.initials: CJ
authors.lastname: Tseng
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000150:complications*; D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000209:etiology / Q000601:surgery*; D014592:Uterine Hemorrhage / Q000209:etiology; D014597:Uterine Rupture / Q000209:etiology