ArticleQuantitative imaging in medicine and surgery2026
Management and outcomes of heterotopic cesarean scar pregnancies: a single-center retrospective case series.
Article in Quantitative imaging in medicine and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Heterotopic pregnancy (HP) is defined as the coexistence of an intrauterine gestation and an ectopic pregnancy, with heterotopic cesarean scar pregnancy (HCSP) being a rare and high-risk subtype. HCSP occurs when the ectopic embryo implants in the niche of a previous cesarean section (CS) scar, carrying a high risk of life-threatening complications such as uterine rupture and massive bleeding. Currently, there are no universally accepted clinical management guidelines for HCSP. This study aimed to describe the clinical management strategies and outcomes of patients with confirmed HCSP at West China Second University Hospital over a 10-year period, in which all cesarean scar pregnancies (CSPs) occurred with a niche. Methods: A retrospective analysis was conducted on 15 patients diagnosed with HCSP in the first trimester at West China Second University Hospital over a 10-year period, where all CSP cases occurred with a niche. Clinical data were extracted, including ultrasound examination results, clinical management approaches (expectant management or surgical treatment), outcome measures [gestational age (GA) at delivery, intrapartum blood loss, neonatal birth weight (NBW), hospital stay], delivery complications, and post-treatment reproductive outcomes. Results: A total of 15 cases were included in this study. The GA at delivery of the fetuses of the five patients with expectant management was 31 Conclusions: For patients with HCSP, expectant management can be successful, especially in cases without fetal heartbeat, but it is associated with a high incidence of delivery complications. Ultrasound-guided D&C after UAE may be a safe and suitable surgical management option for HCSP.
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