Outcome of Cesarean scar pregnancy managed expectantly: systematic review and meta-analysis

Authors: G Calì , I E Timor-Tritsch, J Palacios-Jaraquemada, A Monteaugudo, D Buca, F Forlani, A Familiari, G Scambia, G Acharya, F D’Antonio

Conclusion: CSP with positive embryonic/fetal heart activity managed expectantly is associated with a high burden of maternal morbidity including severe hemorrhage, early uterine rupture, hysterectomy and severe AIP. Despite this, a significant proportion of pregnancies complicated by CSP may progress to, or close to, term, thus questioning whether termination of pregnancy should be the only therapeutic option offered to these women. Expectant management of CSP with no cardiac activity may be a reasonable option in view of the low likelihood of maternal complications requiring intervention, although close surveillance is advisable to avoid adverse maternal outcome.