North Texas GME Research Forum 2024

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Division

North Texas

Hospital

Medical City Arlington

Specialty

Obstetrics & Gynecology

Document Type

Poster

Publication Date

2024

Keywords

ectopic pregnancy, cesarean scar ectopic pregnancy

Disciplines

Female Urogenital Diseases and Pregnancy Complications | Medicine and Health Sciences | Obstetrics and Gynecology

Abstract

Cesarean Scar Pregnancy results from pathologic implantation of a gestational sac into a hysterotomy scar. This rare disease continues to increase in incidence due to the rise of Cesarean delivery in the United States. Current management recommendations by the Society of Maternal Fetal Medicine (SMFM) include termination of pregnancy, or in rare instances, hysterectomy. This case series examines four patients diagnosed with Cesarean Scar Pregnancies that either declined termination or were unable to receive abortion services in the first trimester, and who were managed at the Accreta Center of Excellence at Medical City Dallas Hospital. This novel management strategy included admission to the inpatient antepartum service between 30 and 32 weeks gestation, delivery at 34 weeks gestation via planned cesarean hysterectomy with the Accreta team per accreta protocols (or sooner as indicated), and infant NICU admission. All four patients were delivered with viable neonates, received cesarean hysterectomy, and had less than 2500mL of blood loss at delivery. This case series seeks to examine the current recommendations for cesarean scar pregnancies and propose a safe alternative protocol for CSP expectant management within the Accreta centers of excellence.

Original Publisher

HCA Healthcare Graduate Medical Education

Comments

2nd Place - Case Report Category

Four Cesarean Scar Pregnancies Managed at Accreta Center of Excellence at Medical City Dallas Hospital: A Case Series

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