Demographic and Clinical Determinants of Maternal Complications in Cesarean Scar Pregnancy Surgery: A Cross-Sectional Study in Southwestern Iran

Background & Objective: Given the critical importance of timely diagnosis and treatment of cesarean scar pregnancy (CSP) and the lack of comprehensive studies in this field, this study was conducted to investigate the relationship between maternal complications following CSP surgery and various demographic and clinical factors. Materials & Methods:This cross-sectional study analyzed 350 patients who underwent surgical treatment for CSP at Imam Khomeini Hospital in Ahvaz, Iran, from 2014 to 2023.Demographic and clinical data were collected from medical records.Statistical analyses, including chi-square and t-tests, were performed to assess associations between gestational age, uterine scarring patterns, fetal status, and maternal complications such as blood transfusion, hypervascularity, curettage, laparotomy, hysterectomy, and bladder rupture. Results:The mean gestational age at diagnosis was 49.58 17.07 days.Intrauterine scarring was the most common (68.57%), and 64.29% of fetuses were deceased at diagnosis.Curettage was the primary intervention (84.29%).Higher gestational age was significantly associated with increased need for packed cell transfusion (p<0.001),hypervascularity (p=0.007), and laparotomy (p<0.001).Uterine scarring patterns were significantly associated with packed cell transfusion, hypervascularity, curettage, and laparotomy (p<0.001).Fetal status significantly influenced rates of curettage (p=0.01) and laparotomy (p=0.02).There were no cases of disseminated intravascular coagulation or maternal death. Conclusion:Gestational age, uterine scarring patterns, and fetal status are significant factors associated with maternal complications in CSP surgery.Early diagnosis and intervention may reduce the risk of severe complications.