Tailored Approaches for Management of Cesarean Scar Pregnancy with Early Signs of Marked Vascularization: A Case Series on the Potential Development of Placenta Accreta Spectrum Disorder

Cesarean Scar Pregnancy (CSP) is a condition where an embryo implants in the scar of a prior cesarean section. CSP is becoming more prevalent with rising cesarean rates, and early diagnosis is critical to avoid severe complications such as uterine rupture, hemorrhage, and Placenta Accreta Spectrum Disorder (PASD). This case series reports two cases of CSP managed at a tertiary hospital. The first case involved a 35-year-old woman at 8 weeks of gestation, and the second was a 28-year-old woman at 10 weeks of gestation. One case was complicated by PASD, while the other was not. Both cases highlight the importance of early recognition and tailored management strategies. Ultrasound was key in diagnosing CSP, and surgical management was adapted based on the presence of PASD. The outcomes underscore the need for individualized approaches in CSP management to minimize maternal morbidity and preserve fertility when possible.