Elzewawi Nouar M, Salhi Amina, Khalid Hafasa, AlMojel Shaden, Mallisho Ammar, Elawad Mamoun M
Department of Obstetrics and Gynaecology, King Abdullah Bin Abdulaziz University Hospital, Riyadh, SAU.
Department of Obstetrics and Gynaecology, King Salman Hospital, Riyadh, SAU.
Cureus. 2025 Feb 12;17(2):e78883. doi: 10.7759/cureus.78883. eCollection 2025 Feb.
Objectives Globally, as rates of cesarean section increase, so do the rates of cesarean scar ectopic pregnancies. The objective of this study is to describe our experiences in managing cesarean scar ectopic pregnancy (CSEP) in King Abdullah Bin Abdulaziz University Hospital. Method This retrospective cohort study was conducted at King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia. The study included women of reproductive age who presented with a cesarean scar ectopic pregnancy (CSEP) and a diagnosis confirmed by the transvaginal ultrasound. The suction evacuation was performed by ultrasound-guided suction evacuation. All the relevant data was retrieved from medical records. Results We reported ten CSEPs managed by ultrasound-guided suction evacuation. All ten patients successfully underwent ultrasound-guided suction evacuation for CSEP without complications. Most of the patients experienced minimal blood loss, except one case developed excessive blood loss, which was controlled by balloon tamponade. All the patients were dischargeable on the same day of the procedure or the following day, and they experienced a significant decrease in beta-human chorionic gonadotropin (HCG) levels, ultimately reaching undetectable levels, apart from one case in which the histopathology confirmed partial molar pregnancy and is still undergoing follow-up by beta-HCG till the date of study publication. All patients were discharged with advice for an early scan in subsequent pregnancies. The study revealed ultrasound-guided suction evacuation's effectiveness, safety, and advantages as a minimally invasive and reasonable approach to managing early CSEP. Conclusion Ultrasound-guided suction evacuation can be safely and effectively applied to CSEP management, and it remains one of the most cost-effective methods.
目的 在全球范围内，随着剖宫产率的上升，剖宫产瘢痕部位异位妊娠的发生率也在增加。本研究的目的是描述我们在阿卜杜拉国王本·阿卜杜勒阿齐兹大学医院处理剖宫产瘢痕部位异位妊娠（CSEP）的经验。方法 这项回顾性队列研究在沙特阿拉伯利雅得的阿卜杜拉国王本·阿卜杜勒阿齐兹大学医院进行。该研究纳入了有剖宫产瘢痕部位异位妊娠（CSEP）且经阴道超声确诊的育龄妇女。通过超声引导下吸刮术进行吸宫。所有相关数据均从病历中获取。结果 我们报告了10例经超声引导下吸刮术处理的CSEP。所有10例患者均成功接受了超声引导下CSEP吸刮术，无并发症发生。除1例出现大出血并通过球囊填塞控制外，大多数患者失血极少。所有患者在手术当天或次日即可出院，且β-人绒毛膜促性腺激素（HCG）水平显著下降，最终降至检测不到的水平，但有1例组织病理学确诊为部分性葡萄胎，直至研究发表之日仍在接受β-HCG随访。所有患者出院时均被建议在后续妊娠时尽早进行超声检查。该研究揭示了超声引导下吸刮术作为一种微创且合理的早期CSEP处理方法的有效性、安全性和优势。结论 超声引导下吸刮术可安全有效地应用于CSEP的处理，并且它仍然是最具成本效益的方法之一。
