Author(s)

Chiaki Heshiki¹, Keiko Mekaru¹, Maho Miyagi¹, Sugiko Oishi¹, Kozue Akamine¹, Hitoshi Sugiyama², Tadatsugu Kinjo¹, Hitoshi Masamoto¹, Yoichi Aoki¹

¹Department of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan.
²Science and Technology Group, Okinawa Institute of Science and Technology Graduate University, Onna, Okinawa, Japan.

Background: There is no consensus regarding the optimal treatment for cesarean scar pregnancy (CSP) because treatment efficacy, safety, and the influence on subsequent pregnancy must be taken into consideration. Here we report our experience with 11 cases of CSP and review the literature regarding subsequent pregnancy. Methods: Records of 11 CSP cases that were treated at our hospital were retrospectively reviewed. CSP was treated by local methotrexate (MTX) injection or laparotomic or laparoscopic removal of the gestational mass and myometrial repair. Outcome of subsequent pregnancy after treatment was followed-up until delivery. Results: Local MTX injection was performed for six cases, laparotomic removal of the gestational mass and myometrial repair was performed for two, and laparoscopic removal of the gestational mass and myometrial repair was performed for three. The uterus was preserved in all cases. After CSP treatment, eight pregnancies occurred in five cases, resulting in six live births and two miscarriages. Conclusion: Advantages and disadvantages of various treatment methods for CSP continue to be elucidated. Serum hCG level, location of the gestational mass, thickness of the lower uterine segment at the time of diagnosis, and whether the patient wishes for fertility preservation should be considered when choosing a treatment plan.

Cesarean Scar Pregnancy, Methotrexate, Fertility Preservation

Heshiki, C. , Mekaru, K. , Miyagi, M. , Oishi, S. , Akamine, K. , Sugiyama, H. , Kinjo, T. , Masamoto, H. and Aoki, Y. (2016) Cesarean Scar Pregnancy: A Report of 11 Cases and Review of the Literature Regarding Subsequent Pregnancy. Open Journal of Obstetrics and Gynecology, 6, 8-15. doi: 10.4236/ojog.2016.61002.