- Visibility 503 Views
- Downloads 552 Downloads
- Permissions
- DOI 10.18231/j.ijogr.v.12.i.3.37
-
CrossMark
- Citation
Low implantation of pregnancy: An imitator of cesarean scar ectopic pregnancy
Cesarean scar pregnancy (CSP) is a rare but serious form of ectopic pregnancy where implantation occurs at the site of a prior cesarean scar. This condition poses significant risks, including uterine rupture, severe hemorrhage, and complications like placenta accreta spectrum (PAS). Early and accurate diagnosis through transvaginal ultrasonography is essential for timely intervention. Management strategies vary, from conservative approaches such as methotrexate therapy to surgical options like hysteroscopy and uterine artery embolization, tailored to patient circumstances and reproductive goals. This report outlines a case initially suspected to be CSP, highlighting the diagnostic challenges posed by low implantation mimicking cesarean scar pregnancy, management strategies, and long-term considerations. With increasing cesarean delivery rates globally, CSP requires growing awareness among clinicians and improved management frameworks to optimize maternal outcomes.
References
- Li K, Dai Q. Differential Diagnosis of Cesarean Scar Pregnancies and Other Pregnancies Implanted in the Lower Uterus by Ultrasound Parameters. Biomed Res Int. 2020;2020:8904507.
- Happe SK, Rac MWF, Moschos E, Wells CE, Dashe JS, McIntire DD, et al. Prospective first-trimester ultrasound imaging of low implantation and placenta accreta spectrum. J Ultrasound Med. 2020;39(10):1907–15.
- Jurkovic D, Hillaby K, Woelfer B, Lawrence A, Salim R, Elson CJ. First-trimester diagnosis and management of pregnancies implanted into the lower uterine segment Cesarean section scar. Ultrasound Obstet Gynecol. 2003;21(3):220–7.
- Elson CJ, Salim R, Potdar N, Chetty M, Ross JA, Kirk EJ, et al. Diagnosis and management of ectopic pregnancy: Green-top Guideline No. 21. BJOG. 2016;123(13):e15–55.
- Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management. Obstet Gynecol. 2006;107(6):1373–81.
- Lakshmy SR, Thasleem Z, Parthasarathy P, Banu S. Low lying gestation sac in early pregnancy-an algorithmic approach with ultrasound markers. Obstet Gynecol Int J. 2020;11(2):107–14.
- Godin PA, Bassil S, Donnez J. An ectopic pregnancy developing in a previous caesarian section scar. Fertil Steril. 1997;67(2):398–400.
- Timor-Tritsch IE, Monteagudo A, Cali G, El Refaey H, Kaelin Agten A, Arslan AA. Easy sonographic differential diagnosis between intrauterine pregnancy and cesarean delivery scar pregnancy in the early first trimester. Am J Obstet Gynecol. 2016;215(2):225.
- Popova AK, Vashukova ES, Illarionov RA, Maltseva AR, Pachuliia OV, Postnikova TB, et al. Extracellular vesicles as biomarkers of pregnancy complications. Int J Mol Sci. 2024;25(22):11944.
- Chen G, Ding C, Tang K, Zhang D, Xu Q, Shao L, et al. EP01.02: Automatic diagnosis of Caesarean scar pregnancy based on ultrasound images by the deep learning model. Ultrasound Obstet Gynecol. 2024;64:107. Udayasuriyan et al. / Indian Journal of Obstetrics and Gynecology Research 2025;12(3):588–591 591
- Chen X, Zhang H, Guo D, Yang S, Liu B, Hao Y, et al. Risk of intraoperative hemorrhage during cesarean scar ectopic pregnancy surgery: development and validation of an interpretable machine learning prediction model. EClinicalMedicine. 2024;78:102969.
- Moschos E, Wells CE, Twickler DM. Biometric sonographic findings of abnormally adherent trophoblastic implantations on cesarean delivery scars. J Ultrasound Med. 2014;33(3):475–81.
- Cali G, Forlani F, Timor-Tritsch IE, Palacios-Jaraquemada J, Minneci G, D'Antonio F. Natural history of Cesarean scar pregnancy on prenatal ultrasound: the crossover sign. Ultrasound Obstet Gynecol. 2017;50(1):100–4.
- Morlando M, Buca D, Timor-Tritsch I, Cali G, Palacios- Jaraquemada J, Monteagudo A, et al. Reproductive outcome after cesarean scar pregnancy: A systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2020;99(10):1278–89.
How to Cite This Article
Vancouver
Udayasuriyan KP. Low implantation of pregnancy: An imitator of cesarean scar ectopic pregnancy [Internet]. Indian J Obstet Gynecol Res. 2025 [cited 2025 Oct 03];12(3):588-591. Available from: https://doi.org/10.18231/j.ijogr.v.12.i.3.37
APA
Udayasuriyan, K. P. (2025). Low implantation of pregnancy: An imitator of cesarean scar ectopic pregnancy. Indian J Obstet Gynecol Res, 12(3), 588-591. https://doi.org/10.18231/j.ijogr.v.12.i.3.37
MLA
Udayasuriyan, Kavya Paul. "Low implantation of pregnancy: An imitator of cesarean scar ectopic pregnancy." Indian J Obstet Gynecol Res, vol. 12, no. 3, 2025, pp. 588-591. https://doi.org/10.18231/j.ijogr.v.12.i.3.37
Chicago
Udayasuriyan, K. P.. "Low implantation of pregnancy: An imitator of cesarean scar ectopic pregnancy." Indian J Obstet Gynecol Res 12, no. 3 (2025): 588-591. https://doi.org/10.18231/j.ijogr.v.12.i.3.37