The use of pressure balloons in the treatment of first trimester cesarean scar pregnancy

Best Pract Res Clin Obstet Gynaecol. 2023 Dec:91:102409. doi: 10.1016/j.bpobgyn.2023.102409. Epub 2023 Aug 29.

Abstract

Cesarean scar pregnancy (CSP) is among the most severe complications of cesarean delivery. CSP refers to the abnormal implantation of the gestational sac in the area of the prior cesarean delivery (CD), potentially leading to severe hemorrhage, uterine rupture, or development of placenta accreta spectrum disorders (PAS). The management of women with CSP has not been standardized yet. In women who opted for termination, discussion about the treatments should consider maternal symptoms, gestational age at intervention, and the future reproductive risk. A multitude of treatments, either medical or surgical, for CSP has been reported in the published literature. The present review aims to provide up-to-date information on a recently introduced minimally invasive treatments for CSP, including the single and double balloon catheter. The methodology of using the single or double catheter is described in a step-by-step fashion illustrated by pictures as well as video recordings. Both catheters have their deserved place to be used as a primary method for terminating scar pregnancies as well as using them as adjuncts to other treatments. They were successfully used by multiple individual practitioners and institutions due to their simplicity and low complication rates. The rare, but possible post-procedure complications such as recurrent CSP and enhanced myometrial vascularity are also mentioned.

Keywords: Cesarean scar pregnancy; Outcome; Placenta accrete spectrum.

Publication types

  • Review

MeSH terms

  • Cesarean Section / adverse effects
  • Cicatrix / complications
  • Cicatrix / therapy
  • Female
  • Humans
  • Myometrium
  • Placenta Accreta* / therapy
  • Pregnancy
  • Pregnancy Trimester, First
  • Pregnancy, Ectopic* / etiology
  • Pregnancy, Ectopic* / therapy