Open Journal of Obstetrics and Gynecology, 2020, 10, 526-537
https://www.scirp.org/journal/ojog
ISSN Online: 2160-8806
ISSN Print: 2160-8792
DOI: 10.4236/ojog.2020.1040047 Apr. 20, 2020 526 Open Journal of Obstetrics and Gynecology
Medical Management of Cesarean Scar
Pregnancy at Latifa Hospital Dubai Health
Authority, Dubai, UAE
A. Ammar
1
, F. Nasrallah
1
, H. Adan
1
, J. Ali
1
, M. Mussa
1
, A. B. E. Fazari
1,2*
, N. Alsawalhee
1
1
Latifa Hospital for Women & Children, DHA, Dubai, UAE
2
University of Medical Sciences & Technology, Khartoum, Sudan
Abstract
Introduction: Cesarean scar pregnancy (CSP) is defined as implantation of
gestational sac at the site of cesarean scar. It’s a serious diagnosis that has be-
come more prevalent in recent years and related to the increasing rate of ce-
sarean sections reported worldwide. Identifying these cases and treating them
is challenging, with no agreed upon universal protocol for successful treat-
ment. We aim to evaluate the success rate and outcome of medical manage-
ment for Cesarean scar pregnancy. Methods: It was a retrospective descrip-
tive study of all cesarean scar pregnancies managed at fetal medicine unit at
Latifa Hospital in Dubai, UAE the main obstetrics & Gynecology tertiary
hospital in Dubai Emirate, UAE from 2015 to 2017. Certainly, a set of diag-
nostic criteria were implemented to confirm the diagnosis of CSP. The cases
were then offered our proposed management which is systemic methotrexate
injections ± KCL. Follow up made by serial βhcg and ultrasound scan. The
data were collected used specified data collection sheet for this purpose then
analyzed and presented using statistical package for social sciences (SPSS)
version 26. Results: 33 cases of cesarean scar pregnancies are confirmed and
medically managed during the study period. The study subjects composed of
a group of patients who had a viable CSP and received local KCL injection +
systemic methotrexate, a second group who had non-viable CSP and received
systemic methotrexate 20 cases were viable pregnancies who received com-
bined local potassium chloride plus systemic methotrexate, and 13 were
non-viable received systemic methotrexate only. The mean gestational age at
diagnosis was 8 weeks (SD ± 1.8). On average our cases had a history of 3
previous cesarean sections (range 1 - 6). Overall, the success rate calculated
from our study population for medical management of CSP was 77.8%; this
varied between viable CSP which had a success rate of 66.7% and non-viable
How to cite this paper: Ammar, A., Na-
srallah, F., Adan, H., Ali, J., Mussa, M.,
Fazari, A.B.E. and Alsawalhee, N. (2020)
Medical Management of Cesarean Scar
Pregnancy at Latifa Hospital Dubai Health
Authority, Dubai, UAE. Open Journal of
Obstetrics and Gynecology, 10, 526-537.
https://doi.org/10.4236/ojog.2020.1040047
Received: March 19, 2020
Accepted: April 17, 2020
Published: April 20, 2020
Copyright © 2020 by author(s) and
Scientific Research Publishing Inc.
This work is licensed under the Creative
Commons Attribution International
License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
Open Access