# Cesarean Scar Ectopic Pregnancy: A Retrospective Study of Ultrasound-Guided Suction Evacuation From Saudi Arabia

## TL;DR

This study from Saudi Arabia shows that ultrasound-guided suction evacuation is a safe and effective method for treating cesarean scar ectopic pregnancies.

## Contribution

The paper presents real-world evidence of the safety and effectiveness of ultrasound-guided suction evacuation for CSEP in a Saudi hospital setting.

## Key findings

- Ten patients underwent successful ultrasound-guided suction evacuation with minimal complications.
- All patients showed significant decreases in beta-HCG levels, except one with partial molar pregnancy.
- The procedure was found to be safe, minimally invasive, and cost-effective for early CSEP management.

## Abstract

Objectives

Globally, as rates of cesarean section increase, so do the rates of cesarean scar ectopic pregnancies. The objective of this study is to describe our experiences in managing cesarean scar ectopic pregnancy (CSEP) in King Abdullah Bin Abdulaziz University Hospital.

Method

This retrospective cohort study was conducted at King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia. The study included women of reproductive age who presented with a cesarean scar ectopic pregnancy (CSEP) and a diagnosis confirmed by the transvaginal ultrasound. The suction evacuation was performed by ultrasound-guided suction evacuation. All the relevant data was retrieved from medical records.

Results

We reported ten CSEPs managed by ultrasound-guided suction evacuation. All ten patients successfully underwent ultrasound-guided suction evacuation for CSEP without complications. Most of the patients experienced minimal blood loss, except one case developed excessive blood loss, which was controlled by balloon tamponade. All the patients were dischargeable on the same day of the procedure or the following day, and they experienced a significant decrease in beta-human chorionic gonadotropin (HCG) levels, ultimately reaching undetectable levels, apart from one case in which the histopathology confirmed partial molar pregnancy and is still undergoing follow-up by beta-HCG till the date of study publication. All patients were discharged with advice for an early scan in subsequent pregnancies. The study revealed ultrasound-guided suction evacuation's effectiveness, safety, and advantages as a minimally invasive and reasonable approach to managing early CSEP.

Conclusion

Ultrasound-guided suction evacuation can be safely and effectively applied to CSEP management, and it remains one of the most cost-effective methods.