Available online 16 February 2024, 102746

Cesarean scar pregnancy (CSP) is a rare dangerous condition with still no consensus on standard treatment. Suction curettage has been used as the first-line treatment for CSP with controversial outcomes. This study evaluates efficacy of ultrasound-guided suction curettage (UGSC) followed by cervical-isthmic placement of silicon semirigid three-way foley catheter.

This study included 24 women with CSP. Preoperative ultrasound study was conducted. UGSC followed by placement of catheter was performed in all patients. The success rate and incidence of major complication, surgical time and hospital stay were recorded.

The success rate of UGSC followed by placement of foley catheter was 100%, effectively reduced major complications and none of the patients had a blood loss higher than 900 ml. Median hospital stay was 2 days and median foley stay was 1 day. Surgery had limited last with a median of 17 minutes.

UGSC followed by foley placement is a safe effective treatment for CSP with a clinical resolution of 100%. The catheter is easy to place under ultrasound guidance and prevents bleeding, reducing major procedures to solve the bleeding. Suction curettage in CSP treatment should be performed under ultrasound guidance and followed by cervical-isthmic placement of foley balloon.

Cesarean scar pregnancy (CSP) is a potentially dangerous consequence of a previous cesarean section (CS) [1,2]. The incidence of scar pregnancy is increasing because of the increased frequency of CS and probably thanks to the improvement in ultrasound diagnosis [3,4]. The occurrence of CSP is related to frequency of CS and its true incidence is unknown with approximated incidence between 1/1800 and 1/2500 CS performed [5]. CSP is a type of ectopic pregnancy characterized by the implantation and

The database of patients with CSP admitted and treated at Obstetrics and Gynecology Department of Azienda Ospedaliera San Giovanni Addolorata in Rome, between 2017 and May 2023 was reviewed retrospectively.

An informed, written consent for the curettage, for the uterine insertion of three-way foley catheter and the eventual anonymous data analysis had been proposed and signed by all women included. The study was conducted in accordance with the latest revision of Declaration of Helsinki in 2013.

During the study period 25 patients were diagnosed with CSP and after counselling 24 decided to interrupt the pregnancy with live embryos at the time of the treatment, while 1 patient decided to carry on the pregnancy and went to elective CS with total hysterectomy for Placenta accreta spectrum disorder (placenta previa increta) at 35 weeks of gestational age with no significant complications.

Twenty-four patients were included. Median age was 37 years old (range between 32 and 41 years). All

The present study showed that suction curettage followed by placement of the three-way foley catheter under ultrasound guidance, is a safe and relatively simple surgical technique with few complications and brief hospitalization, allowing a timely intra- and post-operative estimation of the patients' blood loss, with no cases of major bleeding, no need for laparotomy, no need for intensive care and no need for reintervention. So, the technique proposed seems to assure lower risks of

No authors declare conflicts of interest.

This work was not supported by grants.

© 2024 Published by Elsevier Masson SAS.