Misdiagnosis analysis of uterine scar pregnancy after cesarean section

Misdiagnosed uterine scar pregnancy after cesarean section can lead to serious consequences such as uterine rupture and hemorrhagic shock. The present study aimed to analyze the causes and treatment outcomes of misdiagnosed uterine scar pregnancy after cesarean section. A retrospective analysis was conducted on the clinical data of seven patients with cesarean scar pregnancy from the Department of Obstetrics and Gynecology at the 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army (Gansu, China) in order to analyze the causes of misdiagnosis and explore effective treatment methods. All seven cases were misdiagnosed as intrauterine pregnancy, wherein three were threatened with miscarriage of early pregnancy and four with embryonic arrest. In total, three patients experienced bleeding reaching volumes of 800-1,400 ml (cases 1, 4 and 6). After active bilateral uterine artery embolization (cases 1, 2, 4, 5 and 6), a combination of mifepristone and methotrexate was administered, and the patients' bleeding stopped after embolization treatment. These observations suggest that the use of medications or interventional embolization (cases 1, 2, 4, 5 and 6) followed by ultrasound-guided curettage can yield positive benefits and allow for full patient recovery.