Identifying risk factors for recurrent cesarean scar pregnancy A case control study

Capsule:
This is a case-control study of risk factors for recurrent cesarean scar pregnancy. Findings on risk factors might be helpful for the prevention and early diagnosis of the disease.

Authors:
Zhida Qian, M.D., Qingyun Guo, M.D., Lili Huang, M.D.

Volume 102, Issue 1, Pages 129–134.e1

Abstract:

Objective:
To investigate risk factors for recurrent cesarean scar pregnancies.

Design:
Case-control study.

Setting:
University hospital.

Patient(s):
Twenty-one women with recurrent cesarean scar pregnancies and 42 women with single cesarean scar pregnancies.

Intervention(s):
None.

Main Outcome Measure(s):
Risk factors and historical factors that might be predisposing factors in recurrent cesarean scar pregnancy.

Result(s):
The risk factors of recurrent cesarean scar pregnancy were cesarean delivery history in rural community hospitals (odds ratio [OR] 4.75), thinner lower uterine segment (≤5 mm; OR 7.10), gestational sac bulging into the uterovesical fold (OR 6.25), history of irregular vaginal bleeding or lower abdominal pain in an earlier cesarean scar pregnancy (OR 3.52), and early termination (≤56 days) of the first cesarean scar pregnancy (OR 5.85).

Conclusion(s):
These findings provide evidence for the prevention of recurrent cesarean scar pregnancy and early diagnosis of the disease. Early recognition and diagnosis of this disease might be feasible because of the identifiable risk factors. Clinicians should be aware of the possible existence of recurrence. An accurate and prompt diagnosis is crucial to avoid catastrophic complications such as uterine rupture, massive vaginal bleeding and placenta previa/accreta, which might lead to hysterectomy.

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