SMFM consult series #49 on cesarean scar pregnancy

June 12, 2020
Society for Maternal-Fetal Medicine (SMFM)
Society for Maternal-Fetal Medicine (SMFM)

Created in partnership with the Society for Maternal-Fetal Medicine, SMFM was established in 1977 to “give Maternal-Fetal Medicine (MFM) physicians and scientists a place to share knowledge, research and clinical best practices in order to improve care fo

Cesarean scar pregnancy (CSP) is a complication in which an early pregnancy implants in the scar from a prior cesarean delivery. Incidence and recognition of this condition appear to have increased over the past two decades, perhaps due to high worldwide cesarean delivery rates. The clinical presentation is variable, and many women are asymptomatic at presentation. CSP can be difficult to diagnose in a timely fashion. Ultrasound is the primary imaging modality for CSP diagnosis. Expectantly managed CSP is associated with high rates of severe maternal morbidity such as hemorrhage, placenta accreta spectrum (PAS), and uterine rupture. Given these substantial risks, pregnancy termination is recommended after CSP diagnosis. Several surgical and medical treatments have been described for this disorder, but at this time, optimal management remains uncertain.