SynthesisArchives of gynecology and obstetrics2023
Expectant management of viable cesarean scar pregnancies: a systematic review.
Synthesis in Archives of gynecology and obstetrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed, 5 citations in OpenAlex.
- Cesarean Scar Implantation in the Evolution of Placenta Accreta Spectrum: Implications for Recognition and Clinical Management.O&G open · 2026Review
- Correspondence on "Expectant management of viable cesarean scar pregnancies: a systematic review".Archives of gynecology and obstetrics · 2023Article
- Ectopic pregnancy management and treatment strategies: A nationwide survey of Czech gynecological facilities.Women's health (London, England)Observational
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveCesarean scar pregnancy (CSP) is a potentially life-threatening disease that has been steadily increasing in prevalence. Pregnancy termination is usually recommended given the risk of life-threatening complications. In some cases, patients refuse to terminate viable CSPs, even after counseling. Recent studies report that, even with a high burden of possible complications and maternal morbidity, many CSPs progress to live, close to term births. The aim of this study is to further demonstrate the natural history of viable cesarean scar pregnancies.
methodsWe conducted a systematic review of original studies reporting cases of expectant management of CSPs with positive fetal heartbeats.
resultsAfter selection, 28 studies were included in the review, with a total of 398 cases of CSP, 136 managed expectantly and 117 with positive fetal heartbeat managed expectantly. This study confirmed that the majority of patients experience live births, as 78% of patients selected for expectant management experienced live births at or close to term, with 79% developing morbidly adherent placenta, 55% requiring hysterectomy, and 40% having severe bleeding. DISCUSSION: The optimal management protocol for CSP is still to be defined and more studies are needed to further elucidate this rare but rising disease. Our study provides information on the natural history of untreated CSPs and suggests that termination may not be the only option offered to the patient.
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