{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:49:03Z","timestamp":1789566543767,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T00:00:00Z","timestamp":1721865600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Early diagnosis and appropriate management of Cesarean scar pregnancy (CSP) are crucial to prevent severe complications, such as uterine rupture, severe hemorrhage and placenta accreta spectrum disorders. In this article, we provide a step\u2010by\u2010step tutorial for the standardized sonographic evaluation of CSP in the first trimester. Practical steps for performing a standardized transvaginal ultrasound examination to diagnose CSP are outlined, focusing on criteria and techniques essential for accurate identification and classification. Key sonographic markers, including gestational sac location, cardiac activity, placental implantation and myometrial thickness, are detailed. The evaluation process is presented according to assessment of the uterine scar, differential diagnosis, detailed CSP evaluation and CSP classification. This step\u2010by\u2010step tutorial emphasizes the importance of scanning in two planes (sagittal and transverse), utilizing color or power Doppler and differentiating CSP from other low\u2010lying pregnancies. The CSP classification is described in detail and is based on the location of the largest part of the gestational sac relative to the uterine cavity and serosal lines. This descriptive classification is recommended for clinical use to stimulate uniform description and evaluation. Such a standardized sonographic evaluation of CSP in the first trimester is essential for early diagnosis and management, helping to prevent life\u2010threatening complications and to preserve fertility. Training sonographers in detailed evaluation techniques and promoting awareness of CSP are critical. The structured approach to CSP diagnosis presented herein is supported by a free e\u2010learning course available online. \u00a9 2024 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>","DOI":"10.1002\/uog.27604","type":"journal-article","created":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T18:43:10Z","timestamp":1706985790000},"page":"412-418","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["How to perform standardized sonographic examination of Cesarean scar pregnancy in the first trimester"],"prefix":"10.1002","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9009-149X","authenticated-orcid":false,"given":"C.","family":"Verberkt","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Research Institute \u2018Amsterdam Reproduction and Development\u2019 Amsterdam UMC, location VUMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3875-7263","authenticated-orcid":false,"given":"I. 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M.","family":"Jordans","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Research Institute \u2018Amsterdam Reproduction and Development\u2019 Amsterdam UMC, location VUMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6777-5036","authenticated-orcid":false,"given":"T.","family":"Van den Bosch","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Hospitals Leuven  Leuven Belgium"},{"name":"Department of Development and Regeneration KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Timmerman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Hospitals Leuven  Leuven Belgium"},{"name":"Department of Development and Regeneration KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Bourne","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration KU Leuven  Leuven Belgium"},{"name":"Department of Obstetrics and Gynaecology Queen Charlotte's and Chelsea Hospital, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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