Treatment outcomes of cesarean scar pregnancies related to the international classification.

There is a dramatic rise in caesarean deliveries worldwide resulting in more focus on complications in subsequent pregnancies.1, 2 One of these serious complications is a caesarean scar pregnancy (CSP), defined by international experts as “all pregnancies on/in the cesarean scar”.3-5 If a CSP remains unrecognized, this may lead to life-threatening complications including massive hemorrhage, uterine rupture, placental abnormalities, hysterectomy, fetal death and even cases of maternal death are reported.6, 7 Therefore, early recognition and proper management of a CSP may reduce maternal morbidity and mortality. Until now, more than 30 treatments have been reported, including medical, embolization and surgical treatment or a combination of these treatments. However, in literature the optimal approach for CSP in terms of safety and clinical effectiveness has yet to be determined. Given the lack of uniform classification it is difficult to give a critical appraisal of available literature to predict success rates and risks on complications of various treatment options in different situations. Recently, international experts consented on a new ultrasound classification of CSP. The aim of the current study is to study the clinical short term outcomes and reproductive outcomes of subsequent pregnancies after various therapies stratified by type of CSP.

The new classification could be benificial in clincial treatment apporach.

- 3, 6, 12 months

- follow up during pregnancy

- follow-up: 3 years

- Expectant
- Methotrexate
- Curettage
- Laparoscopic niche resection.