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Table 3 Management, complications, and surveillance of the 6 patients diagnosed with CSP included in the case-series report

From: Combination of medical and surgical management in successful treatment of caesarean scar pregnancy: a case report series

Patient Initial treatment Complications Management of complications Hospitalisation
(days)
Imagistic surveillance:
TVUS and color Doppler
hCG surveillance
1 Medical: Methotrexate
1 mg/kg, 5 doses, alternate days
No complications, spontaneous resolution of pregnancy N/A 9 3-months posttreatment: normal uterus and isthmic caesarean scar 98 days follow up until negative
2 Medical:
Methotrexate
1 mg/kg, 5 doses, alternate days
Increase hCG levels
Persistence of pregnancy and local trophoblastic vascularization
Surgical: D&C and local haemostasis with Foley catheter for 48 h 11 still on surveillance Decreasing trend of hCG
3 Medical:
Mifepristone,
Methotrexate, 1 mg/kg
Increase hCG levels
Spontaneous miscarriage with heavy vaginal bleeding
Surgical, D&C under US guidance
haemostasis with uterine-vaginal pack
13 6-months post treatment: normal uterus and uterine scar < 10
4 Medical:
Mifepristone, Methotrexate, 1 mg/kg
No complications, spontaneous resolution of pregnancy N/A 10 1-month post treatment
Normal uterus and uterine scar
<  5
5 Surgical: D&C Persistence of vascularised trophoblast Medical: Methotrexate, 1 mg/kg x 1dose
Surgical: D&C and haemostasis with Foley catheter
11 2-years posttreatment
Normal appearance of anterior wall of the uterus normal and caesarean scar
Follow up another centre
6 Surgical:
emergency D&C
Spontaneous miscarriage with heavy vaginal bleeding Persistence of pregnancy, presence of isthmic mass with rich vascularization and possible accreta Surgical: D&C haemostasis Foley catheter & blood transfusion
Surgical: Total abdominal hysterectomy
9 N/A <  64 mUI/mL
  1. Abbreviations: CSP caesarean section scar, hCG hormone chorionic gonadotroph, N/A not applicable. Hospitalization days counts all days as inpatient until treatment completed and discharged to surveillance