Скачать или смотреть Understanding Caesarean Scar Ectopic Pregnancy: A Complete Guide

🚨 Caesarean Scar Ectopic Pregnancy (CSP): Essential Insights 🚨

Welcome to our channel! In today's video, we delve into Caesarean Scar Ectopic Pregnancy, a rare yet increasingly common form of ectopic pregnancy. Here’s a quick overview of what we cover:

🔍 Introduction
Caesarean Scar Ectopic Pregnancy (CSP) occurs when the gestational sac implants within the scar of a previous caesarean section. With the rise in caesarean deliveries, understanding and managing CSP is crucial for healthcare providers.

📈 Incidence and Diagnosis

Rising Incidence: CSP cases are increasing due to more caesarean sections. Incidence estimates range from 1/1800 to 1/2500 of all pregnancies.
Diagnosis: Early diagnosis is key. Transvaginal ultrasound with color Doppler is the gold standard, and MRI can be used if needed.
🔬 Pathophysiology

Mechanism: CSP involves implantation into the scar tissue from a previous caesarean section, often due to endometrial and myometrial disruption.
Risk Factors: Higher risk in those with previous caesarean sections, particularly for breech presentations.
🤒 Clinical Presentation

Symptoms: Includes slight vaginal bleeding and abdominal discomfort. Severe cases may present with acute pain and significant bleeding.
Complications: Risks include major hemorrhage and potential hysterectomy.
🛠️ Management Options

Medical Management: Systemic methotrexate and local embryocides.
Surgical Management: Options include dilatation and curettage, hysteroscopic resection, and laparoscopic/abdominal resection.
Combined and Sequential Management: Combining chemo-embolisation and surgical removal, or initial medical management followed by surgery.
🔍 Follow-Up and Recurrence

Monitoring: Continuous follow-up until complete resolution, including hCG level monitoring and ultrasound assessments.
Recurrence Risk: CSP recurrence ranges from 3.2% to 5.0%, higher with thinner myometrial thickness.
🤰 Future Pregnancies

Early Monitoring: Close monitoring with early ultrasounds.
Delivery: Subsequent deliveries are typically via caesarean section to minimize risks.
👩‍⚕️ Conclusion
Managing CSP requires a multidisciplinary approach and significant expertise to prevent complications. Preventive strategies should focus on reducing unnecessary caesarean sections and emphasizing the long-term risks associated with CSP, such as placenta accreta, when counseling patients.

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