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Hum. Reprod. Advance Access originally published online on April 20, 2007
Human Reproduction 2007 22(7):2012-2015; doi:10.1093/humrep/dem078
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Reproductive outcomes of women with a previous history of Caesarean scar ectopic pregnancies

J. Ben Nagi, S. Helmy, D. Ofili-Yebovi, J. Yazbek, E. Sawyer and D. Jurkovic1

Early Pregnancy and Gynaecology Assessment Unit, King's College Hospital, Denmark Hill, London SE 5 8RX, UK

1 Correspondence address. Tel: +44 207 346 3168; Fax: +44 207 346 3471; E-mail: davor.jurkovic{at}kcl.ac.uk

BACKGROUND: Caesarean scar ectopic pregnancy is associated with a number of significant complications. In this study, we report on subsequent reproductive outcomes in a group of women following successful treatment of their scar pregnancies.

METHODS: The study included those women who received treatment for their Caesarean scar pregnancies between April 1999 and October 2005. Their ability to conceive, the time it took to become pregnant and outcomes of subsequent pregnancies were all recorded.

RESULTS: 40 women with Caesarean scar pregnancies were managed in our unit. The uterus was conserved in 38/40 cases. Follow-up data were available in 29/38 (76%) of women. Twenty-four out of 29 (83%) attempted to become pregnant. Twenty-one out of 24 [88%, 95% confidence interval (CI): 75–100] women conceived spontaneously. Twenty out of 21 (95%, 95% CI: 86–100) pregnancies were intrauterine and one woman (5%, 95% CI: 0–14) had a recurrent scar ectopic. Thirteen out of 20 (65%, 95% CI: 44–86) intrauterine pregnancies appeared normal. Nine out of 13 (69%) were delivered by Caesarean section. Seven out of 20 (35%, 95% CI: 14–56) intrauterine pregnancies ended in spontaneous abortions.

CONCLUSIONS: Our study shows that reproductive outcomes following treatment of caesarean scar ectopic pregnancies are favourable. The risk of complications including recurrent scar implantation appears to be low.

Key words: Caesarean section/Caesarean scar ectopics/management/fertility/pregnancy outcomes

Submitted on December 13, 2006; resubmitted on February 13, 2007; accepted on February 15, 2007.


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