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Ultrasound in Emergency Medicine| Volume 60, ISSUE 2, P216-219, February 2021

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Point-of-Care Ultrasound Diagnosis of Cesarean Scar Ectopic Pregnancy: A Case Series

      Abstract

      Background

      A cesarean scar pregnancy (CSP) is a clinically important form of ectopic pregnancy that carries a high risk of maternal morbidity and mortality. As the rate of cesarean sections has risen, this diagnosis is becoming an increasingly important consideration for providers caring for patients in early pregnancy.

      Case Report

      We present three cases of CSPs in which point-of-care ultrasound expedited the diagnosis and treatment in the emergency department.

      Why Should an Emergency Physician Be Aware of This?

      Given the risks of an undiagnosed CSP, the increasing incidence of CSP, and the number of effective treatment options available in early gestation, the prompt and accurate diagnosis of CSP remains crucial to its successful management. As such, it is an important diagnosis for the emergency physician to consider when evaluating a patient in early pregnancy.

      Keywords

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      References

        • Murray H.
        • Baakdah H.
        • Bardel T.
        • et al.
        Diagnosis and treatment of ectopic pregnancy.
        Can Med Assoc J. 2005; 173: 905-912
        • Ash A.
        • Smith A.
        • Maxwell D.
        Caesarean scar pregnancy.
        BJOG. 2007; 114: 253-263
        • MacDorman M.F.
        • Menacker F.
        • Declercq E.
        Cesarean birth in the United States: epidemiology, trends, and outcomes.
        Clin Perinatol. 2008; 35: 293-307
      1. Understanding cesarean rates.
        (Available at:)
        https://www.cesareanrates.org/
        Date accessed: August 1, 2020
        • Timor-Tritsch I.E.
        • Monteagudo A.
        • Santos R.
        • et al.
        The diagnosis, treatment, and follow-up of cesarean scar pregnancy.
        Am J Obstet Gynecol. 2012; 207: 44.e1
        • Osborn D.A.
        • Williams T.R.
        • Craig B.M.
        Cesarean scar pregnancy: sonographic and magnetic resonance imaging findings, complications and treatment.
        J Ultrasound Med. 2012; 31: 1449-1456
        • Riaz R.M.
        • Williams T.R.
        • Craig G.M.
        • et al.
        Cesarean scar ectopic pregnancy: imaging features, current treatment options, and clinical outcomes.
        Abdom Imaging. 2015; 40: 2589-2599
        • Rotas M.A.
        • Haberman S.
        • Levgur M.
        Cesarean scar ectopic pregnancies: etiology, diagnosis, and management.
        Obstet Gynecol. 2006; 107: 1373-1381
        • Jurkovic D.
        • Hillaby K.
        • Woelfer B.
        • et al.
        First-trimester diagnosis and management of pregnancies implanted into the lower uterine caesarean section scar.
        Ultrasound Obstet Gynecol. 2003; 21: 220-227
        • American College of Emergency Physicians Policy Statement
        Ultrasound guidelines: emergency, point-of-care, and clinical ultrasound guidelines in medicine.
        (Available at:)
        • Kim D.J.
        • Welch M.
        • Kendall J.L.
        A case of cesarean scar ectopic: a rare but important form of ectopic pregnancy.
        Crit Ultrasound. 2011; 3: 55-57
        • Uysal F.
        • Uysal A.
        • Adam G.
        Cesarean scar pregnancy.
        J Ultrasound Med. 2013; 32: 1295-1300