EP16.26: Outcome of expectantly managed CSP continued to viability: data from the international Caesarean scar pregnancy registry

To assess the outcome of women with a viable CSP who continued their pregnancy to ≥23+0 weeks and compared the outcome between women who had third trimester ultrasound signs of PAS with those who did not. The CSP-registry collects anonymised ultrasound and clinical data of individual CSP patients on a secure digital information platform. Cases were uploaded by 36 participating centres in 20 countries. Women who underwent treatment for CSP <23 weeks were reported separately. Out of 708 cases in the CSP registry, 115 (16.2%) women with viable CSP continued their pregnancy of which 77 (66.9%) reached a viable gestation (≥23+0). 35/77 (45.5%) women had ultrasound and/or MRI suspicion of PAS before delivery, 42/77 (54.5%) did not. 24/35 (86.6%) with antenatal suspicion of PAS and 19/42 (45.3%) without PAS suspicion underwent peripartum hysterectomy. 27/35 (77.1%) of suspected PAS cases and 11/42 (26.2%) unsuspected PAS cases had a positive histopathology confirming PAS. 25/43 (58.1%) of hysterectomy cases started as type 2 CSPs. Women continuing their CSP should deliver in a tertiary obstetric centre with dedicated PAS service as even those without signs of PAS have a high risk of requiring a peripartum hysterectomy. Almost 2 out of 3 type 2 CSPs had a peripartum hysterectomy.