Cesarean scar pregnancy is a precursor of morbidly adherent placenta

Aim and Objective: This study aimed to explore the plasma free amino acid (FAA) and carnitine levels in pregnant women with cesarean scar pregnancy (CSP), and to compare them with those of healthy pregnant women. Materials and Methods: This prospective and randomized controlled study was conducted in patients admitted to Harran University Medical Faculty Hospital Obstetrics Clinic between January 2018 and January 2019. A total of 60 patients were included in the study, and the patients were divided into two groups: CSP group (n = 30) and healthy pregnant group as the control group (n = 30). The blood samples were taken from the participants between 7 - 12 weeks of gestation. Twentyseven carnitines and their esters and 14 FAAs were analysed by liquid chromatography – mass spectrometry (LC-MS/MS). Results: The mean plasma concentrations of some carnitines, including C2, C5, C5-OH, C5-DC, C6, C8-1, C12, C14, C14- 1, C14-2, C16, C16-1, C18, and C18-1 were significantly higher in CSP group than in the control group. However, other carnitines, including C0, C3, C4, C4-DC, C5-1, C6-DC, C8, C8-DC, C10, C10-1, C18-1-OH, and C18-2 were similar in both groups. The plasma levels of some FAAs, including Methyl Glutaryl, Leu, Met, Phe, Arg, Orn, and Glu values were significantly higher in CSP group than in the control group. However, there was no statistically significance in other FAA levels, including Val, Asa, Tyr, Asp, Ala, Cit, and Gly between the two groups. Additionally, Pearson’s correlation analysis showed that there were significantly positive correlations between many FAA and carnitine values. Conclusion: Since several plasma carnitine and FAA levels were higher in CSP group than in the control group, we think that scar pregnancy increases metabolic need for myometrial invasion. Also, we think that these results may be useful in clinical practice for CSP diagnosis.

Download Full-text

Successful treatment of cesarean scar pregnancy with the Rendezvous-technique after conservative treatment with cook-catheter and methotrexate

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/j.ejogrb.2018.08.574 ◽

2019 ◽

Vol 234 ◽

pp. e237-e238

Author(s):

Heike Willi ◽

Gwendolin Manegold-Brauer ◽

Viola Heinzelmann-Schwarz ◽

Bernhard Fellmann-Fischer

Keyword(s):

Conservative Treatment ◽

Successful Treatment ◽

Cesarean Scar Pregnancy ◽

Cesarean Scar ◽

Rendezvous Technique

Download Full-text

Risk factors for poor hemostasis of prophylactic uterine artery embolization before curettage in cesarean scar pregnancy

Journal of International Medical Research ◽

10.1177/0300060520964379 ◽

2020 ◽

Vol 48 (10) ◽

pp. 030006052096437

Author(s):

Hongan Tian ◽

Shunzhen Li ◽

Wanwan Jia ◽

Kaihu Yu ◽

Guangyao Wu

Keyword(s):

Risk Factors ◽

Blood Supply ◽

Uterine Artery Embolization ◽

Uterine Artery ◽

Embolic Agent ◽

Artery Embolization ◽

Cesarean Scar Pregnancy ◽

Cesarean Scar ◽

Hemorrhage Volume ◽

Gestational Sac

Objective To observe the hemostatic effect of prophylactic uterine artery embolization (UAE) in patients with cesarean scar pregnancy (CSP) and to examine the risk factors for poor hemostasis. Methods Clinical data of 841 patients with CSP who underwent prophylactic UAE and curettage were retrospectively analyzed to evaluate the hemorrhage volume during curettage. A hemorrhage volume ≥200 mL was termed as poor hemostasis. The risk factors of poor hemostasis were analyzed and complications within 60 days postoperation were recorded. Results Among the 841 patients, 6.30% (53/841) had poor postoperative hemostasis. The independent risk factors of poor hemostasis were gestational sac size, parity, embolic agent diameter (>1000 μm), multivessel blood supply, and incomplete embolization. The main postoperative complications within 60 days after UAE were abdominal pain, low fever, nausea and vomiting, and buttock pain, with incidence rates of 71.22% (599/841), 47.44% (399/841), 39.12% (329/841), and 36.39% (306/841), respectively. Conclusions Prophylactic UAE before curettage in patients with CSP is safe and effective in reducing intraoperative hemorrhage. Gestational sac size, parity, embolic agent diameter, multivessel blood supply, and incomplete embolization of all arteries supplying blood to the uterus are risk factors of poor hemostasis.

Download Full-text

Extreme enhanced myometrial vascularity following cesarean scar pregnancy: a new diagnostic entity

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2021.1897564 ◽

2021 ◽

pp. 1-12

Author(s):

Ilan E. Timor-Tritsch ◽

W. Meredith McDermott ◽

Ana Monteagudo ◽

Giuseppe Calί ◽

Fabiana Kreines ◽

...

Keyword(s):

Cesarean Scar Pregnancy ◽

Cesarean Scar

Download Full-text