Cesarean Scar Pregnancy: Three case reports and literature review

Introduction: Cesarean Scar Pregnancy (CSP) is defined as an ectopic pregnancy in which the gestational sac implants on the surgical scar of a previous cesarean section or isthmocele.Despite its low incidence, the diagnosis presents a significant difficulty, and a false negative diagnosis can lead t...

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Main Authors: Esther Ruiz Pérez, Cristina Álvarez Colomo, Victoria Pascual Escudero, Álvaro Sanz Díaz-Heredero, Lidia Casamayor Del Nogal, Marta Ibáñez Nieto, Sandra Canales Martínez, Jimena Bayón Pascual, Mónica Simón de la Fuente, Mónica Consuelo Horstmann Sendagorta
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:European Journal of Obstetrics & Gynecology and Reproductive Biology: X
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590161325000432
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author Esther Ruiz Pérez
Cristina Álvarez Colomo
Victoria Pascual Escudero
Álvaro Sanz Díaz-Heredero
Lidia Casamayor Del Nogal
Marta Ibáñez Nieto
Sandra Canales Martínez
Jimena Bayón Pascual
Mónica Simón de la Fuente
Mónica Consuelo Horstmann Sendagorta
author_facet Esther Ruiz Pérez
Cristina Álvarez Colomo
Victoria Pascual Escudero
Álvaro Sanz Díaz-Heredero
Lidia Casamayor Del Nogal
Marta Ibáñez Nieto
Sandra Canales Martínez
Jimena Bayón Pascual
Mónica Simón de la Fuente
Mónica Consuelo Horstmann Sendagorta
author_sort Esther Ruiz Pérez
collection DOAJ
description Introduction: Cesarean Scar Pregnancy (CSP) is defined as an ectopic pregnancy in which the gestational sac implants on the surgical scar of a previous cesarean section or isthmocele.Despite its low incidence, the diagnosis presents a significant difficulty, and a false negative diagnosis can lead to serious complications that may require more aggressive treatments. Objective: The main objective of this study is to present three clinical cases of patients with suspected ectopic pregnancy in the cesarean scar, including a review of the current literature on this condition. Methods: The clinical case data were obtained from the patients’ medical records, including the results of the additional tests performed, as well as subsequent gynecology appointments. On the other hand, a literature review was conducted on ectopic pregnancies in the cesarean scar. Results: During ultrasound examinations of patients with a history of previous cesarean sections, special attention should be paid to identifying the implantation site of the gestational sac to rule out CSP.Due to the limited number of trials and case reports on CSP, there is no consensus on standardized treatment and management. The primary goal is to preserve patient's fertility and avoid severe complications such as massive hemorrhage or uterine rupture. Conclusions: Cesarean Scar Pregnancy (CSP) should be considered among the diagnostic options when finding a gestational sac located in atypical situations in patients with a history of cesarean section.Early diagnosis and treatment are crucial for achieving the best outcomes. A minimally invasive approach should be planned as first-line treatment in all situations where CSP is included in the differential diagnosis.
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spelling doaj-art-e162accb12104803a22a34c38d3a789f2025-08-20T02:06:30ZengElsevierEuropean Journal of Obstetrics & Gynecology and Reproductive Biology: X2590-16132025-06-012610040710.1016/j.eurox.2025.100407Cesarean Scar Pregnancy: Three case reports and literature reviewEsther Ruiz Pérez0Cristina Álvarez Colomo1Victoria Pascual Escudero2Álvaro Sanz Díaz-Heredero3Lidia Casamayor Del Nogal4Marta Ibáñez Nieto5Sandra Canales Martínez6Jimena Bayón Pascual7Mónica Simón de la Fuente8Mónica Consuelo Horstmann Sendagorta9Department of Obstetrics and Gynecology, Hospital Clínico Universitario of Valladolid, Regional Health Management of Castilla y León (SACYL), Spain; Correspondence to: Avenida Ramón y Cajal 3, Valladolid 47005, Spain.Department of Obstetrics and Gynecology, Hospital Clínico Universitario of Valladolid, Regional Health Management of Castilla y León (SACYL), Spain; Department of Pediatrics and Immunology, Obstetrics and Gynecology, Nutrition and Bromatology, Psychiatry, and History of Science, Faculty of Medicine, University of Valladolid, SpainDepartment of Obstetrics and Gynecology, Hospital Clínico Universitario of Valladolid, Regional Health Management of Castilla y León (SACYL), SpainDepartment of Obstetrics and Gynecology, Hospital Clínico Universitario of Valladolid, Regional Health Management of Castilla y León (SACYL), SpainDepartment of Obstetrics and Gynecology, Hospital Clínico Universitario of Valladolid, Regional Health Management of Castilla y León (SACYL), SpainDepartment of Obstetrics and Gynecology, Hospital Clínico Universitario of Valladolid, Regional Health Management of Castilla y León (SACYL), SpainDepartment of Obstetrics and Gynecology, Hospital Clínico Universitario of Valladolid, Regional Health Management of Castilla y León (SACYL), SpainDepartment of Obstetrics and Gynecology, Hospital Clínico Universitario of Valladolid, Regional Health Management of Castilla y León (SACYL), SpainDepartment of Obstetrics and Gynecology, Hospital Clínico Universitario of Valladolid, Regional Health Management of Castilla y León (SACYL), SpainDepartment of Obstetrics and Gynecology, Hospital Clínico Universitario of Valladolid, Regional Health Management of Castilla y León (SACYL), SpainIntroduction: Cesarean Scar Pregnancy (CSP) is defined as an ectopic pregnancy in which the gestational sac implants on the surgical scar of a previous cesarean section or isthmocele.Despite its low incidence, the diagnosis presents a significant difficulty, and a false negative diagnosis can lead to serious complications that may require more aggressive treatments. Objective: The main objective of this study is to present three clinical cases of patients with suspected ectopic pregnancy in the cesarean scar, including a review of the current literature on this condition. Methods: The clinical case data were obtained from the patients’ medical records, including the results of the additional tests performed, as well as subsequent gynecology appointments. On the other hand, a literature review was conducted on ectopic pregnancies in the cesarean scar. Results: During ultrasound examinations of patients with a history of previous cesarean sections, special attention should be paid to identifying the implantation site of the gestational sac to rule out CSP.Due to the limited number of trials and case reports on CSP, there is no consensus on standardized treatment and management. The primary goal is to preserve patient's fertility and avoid severe complications such as massive hemorrhage or uterine rupture. Conclusions: Cesarean Scar Pregnancy (CSP) should be considered among the diagnostic options when finding a gestational sac located in atypical situations in patients with a history of cesarean section.Early diagnosis and treatment are crucial for achieving the best outcomes. A minimally invasive approach should be planned as first-line treatment in all situations where CSP is included in the differential diagnosis.http://www.sciencedirect.com/science/article/pii/S2590161325000432Cesarean Scar PregnancyIsthmoceleEctopic pregnancyCesarean section
spellingShingle Esther Ruiz Pérez
Cristina Álvarez Colomo
Victoria Pascual Escudero
Álvaro Sanz Díaz-Heredero
Lidia Casamayor Del Nogal
Marta Ibáñez Nieto
Sandra Canales Martínez
Jimena Bayón Pascual
Mónica Simón de la Fuente
Mónica Consuelo Horstmann Sendagorta
Cesarean Scar Pregnancy: Three case reports and literature review
European Journal of Obstetrics & Gynecology and Reproductive Biology: X
Cesarean Scar Pregnancy
Isthmocele
Ectopic pregnancy
Cesarean section
title Cesarean Scar Pregnancy: Three case reports and literature review
title_full Cesarean Scar Pregnancy: Three case reports and literature review
title_fullStr Cesarean Scar Pregnancy: Three case reports and literature review
title_full_unstemmed Cesarean Scar Pregnancy: Three case reports and literature review
title_short Cesarean Scar Pregnancy: Three case reports and literature review
title_sort cesarean scar pregnancy three case reports and literature review
topic Cesarean Scar Pregnancy
Isthmocele
Ectopic pregnancy
Cesarean section
url http://www.sciencedirect.com/science/article/pii/S2590161325000432
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