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Caesarean scar pregnancy: a review of management options

Litwicka, Katarzyna; Greco, Ermanno

Current Opinion in Obstetrics & Gynecology: December 2013 - Volume 25 - Issue 6 - p 456–461
doi: 10.1097/GCO.0000000000000023
WOMEN'S HEALTH: Edited by Joseph Aquilina

Purpose of review: The current review aims to provide an overview of the already available and emerging treatment modalities for caesarean scar pregnancy (CSP).

Recent findings: CSP is a type of ectopic gestation associated with a high risk of serious complications. The cause of this condition and the best management are still unclear. However, some medical and surgical treatment modalities have been suggested. The main objectives in the clinical management of CSP should be the prevention of massive blood loss and the conservation of the uterus to maintain further fertility, women's health and quality of life. Current data suggest that expectant management should not be recommended, whereas there are accumulating data suggesting that early diagnosis offers single or combined medical and surgical treatment options avoiding uterine rupture and haemorrhage, thus preserving the uterus and fertility.

Summary: No universal treatment guidelines for management of CSP have been published up to now. The lack of data on the best evidence should encourage any individual case report and further multicentre studies for recommendation establishment.

Assisted Reproduction Centre, European Hospital, Rome, Italy

Correspondence to Katarzyna Litwicka, MD, Assisted Reproduction Centre, European Hospital, Via Portuense 700, 00149 Rome, Italy. Tel: +39 6 65975643; fax: +39 6 6534897; e-mail: Litwicka@yahoo.it

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins