Causes, Assessment and Management of Cesarean Scar Pregnancy

Abstract

Cesarean scar pregnancy (CSP) is on the rise worldwide due to the increasing rate of cesarean sections. It has been attributed to life threatening complications if not diagnosed early and managed aggressively. CSP is still a rare diagnosis, as available literature is mostly observational case series and few random controlled trials (RCT) to date. Treatment of CSP should be evidence based and focus on prevention of severe complications, conservation of fertility and maintaining women's health and quality life. Despite this prominent increase, no universal treatment guidelines have been established till now, and the management of CSP in clinical practice is based on few available published literatures. Treatment should be individualized by using parameters such as hemodynamic status of the patient, beta-hCG levels, imaging features, the desire for future pregnancy and the surgeon's skill. Current data does not support expectant management. In this article, we aim to find the pathophysiology, clinical presentation, most appropriate methods of diagnosis and treatment of CSP.