Table 2 Clinical diagnosis and treatment of 12 patients with first trimester Cesarean scar pregnancies
Case no. | Gestational age at diagnosis (weeks) | Type of pregnancy | Gestational sac of CSP(mm) | CRL(mm) | Viability | Myometrtrial thickness(mm) | Type of treatment | Success | Time after treatment for β-hCG to reach normal level (days) | Time after treatment for subtrophobla-stic flow to disappear (days) | Follow-up information |
|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 6 + 3 | CSP | 22 × 12 | 3.6 | Viable | 2.9 | TVS guidance local MTX + Systemic MTX | No | - | - | Laparotomy with wedge excision of CSP at 6 W+ due to massive vaginal bleeding and abdominal pain after MTX treatment |
2 | 5 + 3 | CSP | 6 × 5 | no | Non-viable | 4.7 | Hysteroscopy | Yes | 38 | 42 | Cured, no attempt at another pregnancy |
3 | 6 + 2 | CSP | 18 × 14 | 2 | Viable | 4.5 | Systemic MTX + TVS guidance D&C | Yes | 52 | 49 | Cured, waiting for another IVF treatment |
4 | 5 + 6 | CSP | 16 × 10 | no | Non-viable | 3.7 | Hysteroscopy | Yes | 32 | 41 | Cured, no attempt at another pregnancy |
5 | 7 + 0 | CSP | 27 × 17 | 5.4 | Viable | 3.3 | UAE + Hysteroscopy | Yes | 44 | 57 | Cured, no attempt at another pregnancy |
6 | 5 + 4 | CSP | 4.8 × 3.4 | no | Non-viable | 4.9 | HIFU + Hysteroscopic guidance suction curettage | Yes | 26 | 30 | Cured, no attempt at another pregnancy |
7 | 6 + 5 | Heterotopic | 16 × 7 | no | Non-viable | 5.9 | Expectant | Yes | - | 77 | Cesarean section due to massive hemorrhage caused by complete placenta previa at 35 W+,ectopic mass (21 × 14 mm) was removed at the same time, and a healthy boy weighing 2.6 kg was born |
8 | 5 + 6 | Heterotopic | 19 × 6 | no | Non-viable | 2.7 | Expectant | Yes | - | 52 | TVS guidance D&C due to IUP termination at 13 W+ |
9 | 7 + 4 | Heterotopic | 20 × 12 | 3 | Non-viable | 5.2 | Expectant | Yes | - | 96 | Second trimester abortion (6 months’ gestation) of IUP |
10 | 6 + 3 | Heterotopic | 4 × 3 | no | Non-viable | 7.4 | Expectant | Yes | - | 69 | Cesarean section due to premature rupture of membranes at 36 W+, a healthy girl weighing 2.9 kg was born; Scar mass disappeared at 22 W+ |
11 | 6 + 3 | Heterotopic | 39 × 8 | 3.4 | Viable | 4.2 | TVS guidance local KCL | Yes | - | 44 | TVS guidance D&C due to IUP termination at 14 W+ |
12 | 7 + 1 | Heterotopic | 27 × 10 | no | Non-viable | 4.1 | Expectant | Yes | - | 118 | IUP was 18 W+ gestation at the time of writing; Retained ectopic mass (32 × 27 mm) |