Early first-trimester transvaginal ultrasound screening for cesarean scar pregnancy in patients with previous cesarean delivery: analysis of the evidence.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: United States NLM ID: 0370476 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6868 (Electronic) Linking ISSN: 00029378 NLM ISO Abbreviation: Am J Obstet Gynecol Subsets: MEDLINE
    • Publication Information:
      Publication: <2005->: New York : Elsevier
      Original Publication: St. Louis.
    • Subject Terms:
      Cicatrix*/diagnostic imaging ; Pregnancy Trimester, First* ; Pregnancy, Ectopic*/diagnostic imaging ; Pregnancy, Ectopic*/etiology ; Cesarean Section*/adverse effects ; Ultrasonography, Prenatal*; Humans ; Female ; Pregnancy ; Placenta Accreta/diagnostic imaging
    • Abstract:
      Obstetric hemorrhage is a leading cause of maternal morbidity and mortality. An important etiology of obstetric hemorrhage is placenta accreta spectrum. In the last 2 decades, there has been increased clinical experience of the devastating effect of undiagnosed, as well as late diagnosed, cases of cesarean scar pregnancy. There is a growing body of evidence suggesting that cesarean scar pregnancy is an early precursor of second- and third-trimester placenta accreta spectrum. As such, cesarean scar pregnancy should be diagnosed in the early first trimester. This early diagnosis could be achieved by introducing regimented sonographic screening in pregnancies of patients with previous cesarean delivery. This opinion article evaluates the scientific and clinical basis of whether cesarean scar pregnancy, with special focus on its early first-trimester discovery, complies with the accepted requirements of a screening test. Each of the 10 classical screening criteria of Wilson and Jungner were systematically applied to evaluate if the criteria were met by cesarean scar pregnancy, to analyze if it is possible and realistic to carry out screening in a population-wide fashion.
      (Copyright © 2024 Elsevier Inc. All rights reserved.)
    • Contributed Indexing:
      Keywords: cesarean scar pregnancy; first trimester; placenta accreta spectrum; pregnancy; screening
    • Publication Date:
      Date Created: 20240702 Date Completed: 20241122 Latest Revision: 20241126
    • Publication Date:
      20241202
    • Accession Number:
      10.1016/j.ajog.2024.06.041
    • Accession Number:
      38955324