Our Summary

This research was conducted to understand the risk factors for a condition called cesarean scar pregnancy (CSP), which is becoming increasingly prevalent in China. CSP is a rare type of ectopic pregnancy where the baby starts to grow in the scar from a previous cesarean section.

The study involved 79 women who had CSP and 69 women who were expecting and had at least one previous c-section but did not have CSP. The researchers looked at their obstetric history and found that 77.2% of the women with CSP had been pregnant three or more times, compared to 36.2% of the women without CSP.

Also, during their previous c-section, 21.5% of the women with CSP had entered the first stage of labor, compared to 43.5% of the women without CSP. Also, 51.9% of the women with CSP had a condition called cephalopelvic disproportion, where the baby’s head or body is too large to pass through the mother’s pelvis, compared to 23.2% of women without CSP.

However, the researchers didn’t find any significant differences between the two groups in terms of their age, whether they had multiple c-sections, the gestational age of their pregnancies, or whether their c-sections were planned or emergency procedures.

In conclusion, having multiple pregnancies, not going into the first stage of labor during a previous c-section, and having cephalopelvic disproportion could increase the risk of CSP.

FAQs

  1. What are the possible risk factors for cesarean scar pregnancy (CSP)?
  2. Is there a difference between CSP and non-CSP patients in terms of maternal age, multiple cesarean sections, gestational age, and type of cesarean section?
  3. What is the incidence of cesarean scar pregnancy in China?

Doctor’s Tip

A doctor might tell a patient that multiple pregnancies, absence of the first stage of labor, and cephalopelvic disproportion are potential risk factors for cesarean scar pregnancy. It is important for patients with a history of cesarean section to be aware of these risk factors and discuss them with their healthcare provider to ensure the best possible outcome for future pregnancies.

Suitable For

Patients who are typically recommended for cesarean section include those with multiple pregnancies, absence of the first stage of labor during previous cesarean delivery, and cephalopelvic disproportion. Other factors such as previous cesarean section due to breech or shoulder presentation may also contribute to the recommendation for cesarean section. It is important for healthcare providers to assess these risk factors in order to provide appropriate care and reduce the risk of complications such as cesarean scar pregnancy.

Timeline

  • Before cesarean section:
  1. Patient has multiple pregnancies, with 77.2% of CSP patients having ≥ 3 pregnancies.
  2. During previous cesarean delivery, 21.5% of CSP patients entered the first stage of labor.
  3. Cephalopelvic disproportion occurred in 51.9% of CSP patients.
  4. 11.4% of CSP patients had undergone cesarean section due to breech and shoulder presentation.
  5. No significant differences were found in maternal age, multiple cesarean sections, gestational age, emergency or elective caesarean section.
  • After cesarean section:
  1. Patients undergo the surgical procedure.
  2. Recovery period begins, with patients needing to rest and take care of their incision site.
  3. Patients may experience post-operative pain and discomfort.
  4. Patients will have follow-up appointments to monitor their healing and recovery process.
  5. Patients will need to take care of their incision site to prevent infection and promote healing.

What to Ask Your Doctor

  1. What are the potential risk factors for cesarean scar pregnancy (CSP)?
  2. How common is CSP in women with a history of previous cesarean sections?
  3. What are the implications of having multiple pregnancies on the risk of developing CSP?
  4. How does the absence of the first stage of labor during a previous cesarean delivery impact the risk of CSP?
  5. What is the significance of cephalopelvic disproportion in relation to the occurrence of CSP?
  6. Are there any specific factors that may increase the likelihood of developing CSP after a cesarean section?
  7. What are the potential complications associated with CSP?
  8. How is CSP diagnosed and treated?
  9. Is there a higher risk of CSP in women who have had cesarean sections for breech or shoulder presentation in the past?
  10. Are there any preventive measures that can be taken to reduce the risk of CSP in women with a history of cesarean sections?

Reference

Authors: Shi M, Zhang H, Qi SS, Liu WH, Liu M, Zhao XB, Mu YL. Journal: Ginekol Pol. 2018;89(4):195-9. doi: 10.5603/GP.a2018.0033. PMID: 29781074