Management of Myomectomy Scar Pregnancy: A Scoping Review
<i>Background</i>: Ectopic pregnancy (EP) is defined as the implantation of an embryo outside the uterine cavity, which can lead to high morbidity and mortality if not diagnosed and treated promptly. A rare form of EP is myomectomy scar pregnancy (MSP), where the embryo implants in a sca...
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MDPI AG
2025-04-01
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| Online Access: | https://www.mdpi.com/1648-9144/61/5/817 |
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| author | Felice Sorrentino Lorenzo Vasciaveo Francesca Greco Elisa Giansiracusa Francesco D’Antonio Alessandro Lucidi Andrea Etrusco Antonio Simone Laganà Guglielmo Stabile Luigi Nappi |
| author_facet | Felice Sorrentino Lorenzo Vasciaveo Francesca Greco Elisa Giansiracusa Francesco D’Antonio Alessandro Lucidi Andrea Etrusco Antonio Simone Laganà Guglielmo Stabile Luigi Nappi |
| author_sort | Felice Sorrentino |
| collection | DOAJ |
| description | <i>Background</i>: Ectopic pregnancy (EP) is defined as the implantation of an embryo outside the uterine cavity, which can lead to high morbidity and mortality if not diagnosed and treated promptly. A rare form of EP is myomectomy scar pregnancy (MSP), where the embryo implants in a scar from a prior myomectomy. Due to its rarity, MSP presents unique diagnostic and therapeutic challenges. This scoping review aims to map the existing literature on MSP to better understand the diagnostic strategies, management options, and clinical outcomes associated with this condition, and to identify gaps in current research. <i>Methods</i>: We conducted a scoping review by searching databases such as PubMed, Scopus, Web of Science, and MEDLINE for studies published between 2003 and 2023. Keywords used in combination included “myomectomy scar pregnancy”, “scar pregnancy”, “leiomyoma”, “uterine myomectomy”, “PAS disorders”, “placenta previa”, and “placenta accreta”. Studies were screened for relevance and eligibility by two independent reviewers. Data were extracted from case reports, retrospective studies, and reviews discussing MSP. <i>Results</i>: From an initial set of 111 studies, 28 papers met the inclusion criteria, comprising 4 retrospective studies and 24 case reports. A total of 44 cases of MSP were analyzed. The majority of diagnoses were made through ultrasound, with magnetic resonance imaging (MRI) used in more complex cases. Surgical interventions, primarily cesarean sections and myometrial repairs, were the most common treatments, while medical therapy with methotrexate was less frequently applied. <i>Conclusions</i>: This scoping review highlights the challenges of diagnosing and managing MSP due to its rarity. Although surgical management remains the primary approach, there is a lack of consensus on the optimal treatment for different clinical scenarios. Further research is needed to establish standardized diagnostic and therapeutic protocols for MSP and to evaluate the long-term outcomes of affected patients. |
| format | Article |
| id | doaj-art-2389df2d5488494b8e42f73ebecc5202 |
| institution | OA Journals |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj-art-2389df2d5488494b8e42f73ebecc52022025-08-20T02:34:01ZengMDPI AGMedicina1010-660X1648-91442025-04-0161581710.3390/medicina61050817Management of Myomectomy Scar Pregnancy: A Scoping ReviewFelice Sorrentino0Lorenzo Vasciaveo1Francesca Greco2Elisa Giansiracusa3Francesco D’Antonio4Alessandro Lucidi5Andrea Etrusco6Antonio Simone Laganà7Guglielmo Stabile8Luigi Nappi9Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71121 Foggia, ItalyDepartment of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71121 Foggia, ItalyDepartment of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71121 Foggia, ItalyDepartment of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71121 Foggia, ItalyCentre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynaecology, University of Chieti, 66100 Chieti, ItalyCentre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynaecology, University of Chieti, 66100 Chieti, ItalyUnit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, ItalyUnit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, ItalyDepartment of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71121 Foggia, ItalyDepartment of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71121 Foggia, Italy<i>Background</i>: Ectopic pregnancy (EP) is defined as the implantation of an embryo outside the uterine cavity, which can lead to high morbidity and mortality if not diagnosed and treated promptly. A rare form of EP is myomectomy scar pregnancy (MSP), where the embryo implants in a scar from a prior myomectomy. Due to its rarity, MSP presents unique diagnostic and therapeutic challenges. This scoping review aims to map the existing literature on MSP to better understand the diagnostic strategies, management options, and clinical outcomes associated with this condition, and to identify gaps in current research. <i>Methods</i>: We conducted a scoping review by searching databases such as PubMed, Scopus, Web of Science, and MEDLINE for studies published between 2003 and 2023. Keywords used in combination included “myomectomy scar pregnancy”, “scar pregnancy”, “leiomyoma”, “uterine myomectomy”, “PAS disorders”, “placenta previa”, and “placenta accreta”. Studies were screened for relevance and eligibility by two independent reviewers. Data were extracted from case reports, retrospective studies, and reviews discussing MSP. <i>Results</i>: From an initial set of 111 studies, 28 papers met the inclusion criteria, comprising 4 retrospective studies and 24 case reports. A total of 44 cases of MSP were analyzed. The majority of diagnoses were made through ultrasound, with magnetic resonance imaging (MRI) used in more complex cases. Surgical interventions, primarily cesarean sections and myometrial repairs, were the most common treatments, while medical therapy with methotrexate was less frequently applied. <i>Conclusions</i>: This scoping review highlights the challenges of diagnosing and managing MSP due to its rarity. Although surgical management remains the primary approach, there is a lack of consensus on the optimal treatment for different clinical scenarios. Further research is needed to establish standardized diagnostic and therapeutic protocols for MSP and to evaluate the long-term outcomes of affected patients.https://www.mdpi.com/1648-9144/61/5/817myomectomyscar pregnancyleiomyomaPAS disorders |
| spellingShingle | Felice Sorrentino Lorenzo Vasciaveo Francesca Greco Elisa Giansiracusa Francesco D’Antonio Alessandro Lucidi Andrea Etrusco Antonio Simone Laganà Guglielmo Stabile Luigi Nappi Management of Myomectomy Scar Pregnancy: A Scoping Review Medicina myomectomy scar pregnancy leiomyoma PAS disorders |
| title | Management of Myomectomy Scar Pregnancy: A Scoping Review |
| title_full | Management of Myomectomy Scar Pregnancy: A Scoping Review |
| title_fullStr | Management of Myomectomy Scar Pregnancy: A Scoping Review |
| title_full_unstemmed | Management of Myomectomy Scar Pregnancy: A Scoping Review |
| title_short | Management of Myomectomy Scar Pregnancy: A Scoping Review |
| title_sort | management of myomectomy scar pregnancy a scoping review |
| topic | myomectomy scar pregnancy leiomyoma PAS disorders |
| url | https://www.mdpi.com/1648-9144/61/5/817 |
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