Outcomes and Complications of Cesarean Scar Pregnancy: A Retrospective Study

Background & Objective: Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy characterized by the implantation of the gestational sac in the uterine scar from a previous cesarean section. The incidence of CSP is rising, attributed to increased cesarean deliveries. This study was performed with aim to evaluate the outcomes and complications associated with CSP treatment at Imam Khomeini Hospital in Ahvaz. Materials & Methods: This retrospective study was conducted on 261 patients diagnosed with CSP. Data were collected regarding demographic characteristics, treatment modalities, and subsequent pregnancy outcomes through patient records and follow-up calls. Treatment options included curettage, conservative management, medical therapy, resection, and hysterectomy. Chi square and one-way ANOVA tests were used to compare the outcomes and complications between the treatment modalities. Results: The mean age of participants was 34.81 ± 9.2 years, with a mean gestational age at diagnosis of 48.74 ± 10.33 days. Following treatment, 96 (36.78%) of patients became pregnant again. The reported complications included infertility 34 (13.03%), recurrent CSP 14 (5.36%), and placenta accreta 15 (5.75%). Additionally, 63 (24.14%) experienced abnormal uterine bleeding, and 25 (9.58%) had abortions in subsequent pregnancies. The complications did not exhibit statistically significant differences between the treatment modalities (P>0.05). Conclusion: The findings of the present study highlight the significant rates of subsequent pregnancies following CSP treatment and the associated complications that may arise. The findings also underscore the need for careful monitoring and individualized management strategies for women with a history of CSP to optimize maternal health outcomes and inform future reproductive planning.