{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T19:43:02Z","timestamp":1789155782845,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2018,3,5]],"date-time":"2018-03-05T00:00:00Z","timestamp":1520208000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2018,3,5]]},"abstract":"<jats:p><jats:italic>Objective<\/jats:italic>. Cesarean scar pregnancy (CSP) is a rare condition that occurs when the pregnancy implants in a cesarean scar. An early diagnosis and a proper management are fundamental to prevent maternal complications. We review and discuss the different treatment employed in our unit to reduce morbidity, preserve fertility, and predict possible complications.<jats:italic> Methods<\/jats:italic>. The reported treatment has been expectant management, operative hysteroscopy approach, and intramuscular injection of 50\u2009mg methotrexate (MTX), followed by cervical dilation and manual vacuum aspiration (D&amp;S) with a Karman cannula under ultrasound guidance, uterine artery embolization (UAE), and manual vacuum aspiration under ultrasound guidance and uterine artery embolization before surgical laparotomic resection.<jats:italic> Results<\/jats:italic>. Complications were more frequent in women with a history of three or more cesarean section deliveries and with a myometrial thickness thinner than 2\u2009mm. MTX and D&amp;S treatment appear to be most effective and safe at the early age of pregnancy, while UAE and D&amp;S are related to the highest risk of complication in any age of pregnancy.<jats:italic> Conclusion<\/jats:italic>. An appropriate preoperative diagnostic evaluation, the identification of cases at higher risk, and those eligible for a conservative treatment are fundamental to reduce complications.<\/jats:p>","DOI":"10.1155\/2018\/6486407","type":"journal-article","created":{"date-parts":[[2018,3,5]],"date-time":"2018-03-05T18:32:00Z","timestamp":1520274720000},"page":"1-9","source":"Crossref","is-referenced-by-count":48,"title":["Management of Cesarean Scar Pregnancy: A Single-Institution Retrospective Review"],"prefix":"10.1155","volume":"2018","author":[{"given":"P.","family":"Giampaolino","sequence":"first","affiliation":[{"name":"Department of Public Health, University of Naples Federico II, Via S. 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