12. Role of ultrasonography in the diagnosis, grading and treatment of cesarean-section scar pregnancy
Main Article Content
Abstract
Our aim is to evaluate the role of ultrasonography in the diagnosis, grading and treatment of cesarean-section scar pregnancy (CSP). The study included 66 patients, average age 35 ± 4.9 (24 - 45). The cases encountered in grades II, III, and IV were: 42 (63.6%), 18 (27.2%), and 6 (9.1%). The mean indices of gestational age, gestational sac size, residual uterine muscle thickness, and blood loss due to termination of pregnancy differed between classes on SA (p < 0.05). Methods of abortion depend on the grade of CSP, with additional invasive treatment corresponding to a higher grade. Grade II is primarily embryo aspiration alone or in combination with balloon insertion. If there is a fetal heart rate in grade II, MTX should be used before aspiration. If it is rich in blood vessels in grade III, it should be embolized before aspiration. In contrast, grade IV requires open surgery, switching to open surgery when aspiration fails. Notably, the embolization cases prior to aspiration, even at grade III, did not necessitate surgery, and the blood loss was minimal. Hence, ultrasound is noteworthy in assessing the lesions and the classification of CSP, which is useful for deciding an appropriate and effective treatment method for each patient.
Article Details
Keywords
Cesarean section pregnancy, transvaginal ultrasound, embryo aspiration
References
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