Caesarean scar pregnancy
Caesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy where the gestational sac implants within the scar tissue of a previous caesarean section incision.
Early diagnosis and appropriate management of Caesarean Scar Pregnancy are crucial to prevent complications such as scar rupture, severe bleeding, and the need for emergency surgery. Treatment options include medical management to stop the growth of the gestational sac or surgical intervention to remove the gestational sac via laparoscopy or open surgery.
Caesarean Scar Pregnancy is a rare and potentially dangerous condition. Any woman with a history of caesarean section who experiences abnormal bleeding or abdominal pain during pregnancy should seek immediate medical attention by a Gynaecologist for proper evaluation and management.
The pathogenesis features of Caesarean Scar Pregnancy:
The exact pathogenesis of Caesarean Scar Pregnancy is not fully understood. It is believed to occur due to the abnormal invasion of trophoblastic cells into the scar tissue of the previous cesarean section incision.
The clinical features of Caesarean Scar Pregnancy:
1. Delayed or abnormal menstruation: Women with a cesarean scar pregnancy may experience irregular or delayed menstrual cycles. They may also have positive pregnancy test results.
2. Vaginal bleeding: Vaginal bleeding is a common symptom of Caesarean Scar Pregnancy. It may range from light spotting to heavy bleeding and can occur at irregular intervals. The bleeding may be painless or associated with abdominal pain or discomfort.
3. Abdominal pain: Some women may experience abdominal pain, typically located in the lower abdomen. The pain may be mild or severe and can be continuous or intermittent. It may also radiate to the back or shoulder.
4. Abnormal ultrasound findings: Transvaginal ultrasound is the main diagnostic tool for Caesarean Scar Pregnancy. It can reveal the presence of the gestational sac within the scar tissue of the previous cesarean section incision. The gestational sac is typically seen in the anterior lower uterine segment, near the bladder.
5. Rupture of the scar: If left untreated, Caesarean Scar Pregnancy can lead to the rupture of the scar tissue, which can cause severe abdominal pain, heavy bleeding, and signs of shock. Rupture of the scar is a life-threatening complication that requires immediate medical attention.
6. Elevated beta-human chorionic gonadotropin (β-hCG) levels: Blood tests to measure β-hCG levels may show higher than normal levels in Caesarean Scar Pregnancy. However, β-hCG levels alone cannot confirm the diagnosis and must be combined with ultrasound findings.