An Investigation of the Placental Implantation Location in Cesarean Scar Pregnancy

Abstract

Background and Objective: Cesarean Scar Pregnancy (CSP) is a rare and life-threatening complication that involves implantation of a gestational sac at the location of a previous cesarean scar. The presence of a cesarean scar in the uterus can have a significant effect on the placental implantation location. Knowing more about the location of placental implantation in CSP can help manage and prevent the threatening complications of this disorder. The aim of this study is to investigate the placental implantation location in cesarean scar pregnancies. Methods: This cross-sectional study was conducted on 44 patients diagnosed with CSP in the first trimester of pregnancy at Imam Khomeini Hospital in Ahvaz from March 2020 to February 2022. Demographic and clinical information of mothers, number of pregnancies and previous cesarean deliveries, and ultrasound results and placental location were reviewed based on the patients' medical records. The location of the placenta was determined and checked based on four anatomical locations in the endometrial cavity by transabdominal ultrasound between the 11th and 14th weeks of pregnancy. Findings: The mean age of the patients was 33.95±5.09 years. The number of previous cesarean sections was between 1 and 4 and the average was 2.32±0.93. The most common location of the placenta was anterior (61.4%), followed by fundal (29.5%) and posterior (9.1%). The number of previous cesarean deliveries did not have a significant effect on the placental implantation location. Conclusion: The results of this study showed that although the most common placental implantation location in CSP is the anterior location, the posterior placenta can also be present in scar pregnancy and it is not necessary to be in the anterior placenta to make the diagnosis of CSP.

Keywords

• cesarean scar pregnancy
• placental location
• cesarean section
• ectopic pregnancy.