Different Treatment Modalities for Cesarean Scar Pregnancies in Sulaimani Maternity Teaching Hospital

Background and objectives: Cesarean scar ectopic pregnancy is one of the most severe complications of cesarean delivery. Thus, we aimed to evaluate the cesarean scar ectopic pregnancy and treatment modalities. Methods: A cross-sectional study was conducted on 30 cesarean scar ectopic pregnant women who attended the Sulaimani Maternity Teaching Hospital, from May 2022 to May 2023. The cesarean scar ectopic pregnancy among studied women was diagnosed with ultrasound, and then a validated questionnaire was used to collect their sociodemographic and clinical data. Blood samples were collected to estimate the Beta-Human Chorionic Gonadotrophin hormone level. Results: Most women (83.3%) were aged 20-40 years, overweight (46.7%), had bleeding (56.7%), endogenous scar (83.3%), and two caesarean section histories (33%). Moreover, most women (60%) had surgical treatment, and had a Beta-Human Chorionic Gonadotrophin level of >10,000 mIU/mL. The fetal heart rate was negative in most women (77.78%) who needed surgical treatments, while it was positive in 58.33% of women who required systemic methotrexate with suction curettage (p=0.044). Furthermore, most patients in both groups (83.33%) had endogenous scars (p=1.0). Bleeding was the most prevalent complaint in both groups (p=0.369). Suction curettage was the most practiced modality in a group of surgical therapy (55.56%), while systemic methotrexate with suction curettage was the most practiced in another treatment modality group (58.33%). Conclusions: Surgery alone or combination therapy are effective and safe treatment methods for cesarean scar ectopic pregnancy that were not affected by maternal sociodemographic and clinical features.