Identifying risk factors for recurrent cesarean scar pregnancy: a case-control study.
OBJECTIVE
To investigate risk factors for recurrent cesarean scar pregnancies.


METHODS
Case-control study.


METHODS
University hospital.


METHODS
Twenty-one women with recurrent cesarean scar pregnancies and 42 women with single cesarean scar pregnancies.


METHODS
None.


METHODS
Risk factors and historical factors that might be predisposing factors in recurrent cesarean scar pregnancy.


RESULTS
The risk factors of recurrent cesarean scar pregnancy were cesarean delivery history in rural community hospitals (odds ratio [OR] 4.75), thinner lower uterine segment (≤5 mm; OR 7.10), gestational sac bulging into the uterovesical fold (OR 6.25), history of irregular vaginal bleeding or lower abdominal pain in an earlier cesarean scar pregnancy (OR 3.52), and early termination (≤56 days) of the first cesarean scar pregnancy (OR 5.85).


CONCLUSIONS
These findings provide evidence for the prevention of recurrent cesarean scar pregnancy and early diagnosis of the disease. Early recognition and diagnosis of this disease might be feasible because of the identifiable risk factors. Clinicians should be aware of the possible existence of recurrence. An accurate and prompt diagnosis is crucial to avoid catastrophic complications such as uterine rupture, massive vaginal bleeding and placenta previa/accreta, which might lead to hysterectomy.
Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
Zhi-Da
ZD
Qian
Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
Qing-Yun
QY
Guo
Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China. Electronic address: fbhuanglili@163.com.
Li-Li
LL
Huang
D015746:Abdominal Pain / Q000209:etiology; D000032:Abortion, Therapeutic; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D016009:Chi-Square Distribution; D002921:Cicatrix / Q000000981:diagnostic imaging / Q000209:etiology*; D042241:Early Diagnosis; D005260:Female; D006764:Hospitals, Community; D006780:Hospitals, Rural; D006785:Hospitals, University; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000150:complications
Cesarean scar pregnancy; recurrent; risk factors