{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:39:02Z","timestamp":1787841542737,"version":"build-2784847793"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Cesarean scar pregnancy (CSP) is a rare long-term complication after cesarean delivery. In clinical practice, its diagnosis and management is very important because it may be associated with serious consequences. Although a wide range of treatment options have been reported, the best treatment is unrecognized yet. This study aimed to evaluate the outcomes of laparoscopy in CSP.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n This non-randomized single-arm clinical trial was conducted on 43 CSP patients who were referred to the educational and medical centers of Isfahan University of Medical Science from 2021 to 2022. All the patients were treated by laparoscopy, and during follow-up, the pregnancy test was measured weekly until the test was negative, and an ultrasound was performed 6 months later. Myometrial thickness and occurrence of isthmocele were checked and recorded. Abnormal uterine bleeding or pelvic pain were also evaluated 6 months later.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Mean time of surgery was 55.12 \u00b1 10.61 minutes, and the rate of intraoperative bleeding was 62.93 \u00b1 24.00 cc. Four cases had excess intraoperative bleeding: two of them received packed cells, and two led to laparotomy. After surgery, the time to negative pregnancy test was 19.21 \u00b1 5.50 days and 4 (10.3%) patients had isthmocele in follow-up sonography. Human chorionic gonadotropin hormone (BHCG) decreased significantly after surgery (percentage reduction: 97.71 \u00b1 3.80;\n P<\/jats:italic>\n value < 0.001) and myometrial thickness increased significantly (percentage increase: 46.94 \u00b1 28.66;\n P<\/jats:italic>\n value < 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Laparoscopic excision of a CSP is an effective and feasible technique with the advantage of an immediate myometrial reconstruction.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/abr.abr_345_22","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T08:11:38Z","timestamp":1722240698000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Outcomes of Laparoscopic Approach to Cesarean Scar Pregnancy (CSP)"],"prefix":"10.4103","volume":"13","author":[{"given":"Safoura","family":"Rouholamin","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasrin","family":"Ghasemi Toudeshkchuei","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Hashemi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Allameh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elham","family":"Naghshineh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Shahid Beheshti Hospital, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,7]]},"reference":[{"key":"R1-20240830","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.ejogrb.2016.02.039","article-title":"Reproductive outcomes following cesarean scar pregnancy-A case series and review of the literature","volume":"200","author":"Gao","year":"2016","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"R2-20240830","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.placenta.2011.11.010","article-title":"Placenta accreta: Pathogenesis of a 20th century iatrogenic uterine disease","volume":"33","author":"Jauniaux","year":"2012","journal-title":"Placenta"},{"key":"R3-20240830","doi-asserted-by":"crossref","first-page":"682368","DOI":"10.3389\/fmed.2021.682368","article-title":"Approaches in the treatment of cesarean scar pregnancy and risk factors for intraoperative hemorrhage: A retrospective study","volume":"8","author":"Lin","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"R4-20240830","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1002\/uog.12334","article-title":"Changes in cesarean section scar dimensions during pregnancy: A prospective longitudinal study","volume":"41","author":"Naji","year":"2013","journal-title":"Ultrasound Obstet Gynecol"},{"key":"R5-20240830","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/S0140-6736(09)61870-5","article-title":"Method of delivery and pregnancy outcomes in Asia: The WHO global survey on maternal and perinatal health 2007-08","volume":"375","author":"Lumbiganon","year":"2010","journal-title":"Lancet"},{"key":"R6-20240830","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1002\/uog.17568","article-title":"Outcome of cesarean scar pregnancy managed expectantly: Systematic review and meta-analysis","volume":"51","author":"Cali","year":"2018","journal-title":"Ultrasound Obstet Gynecol"},{"key":"R7-20240830","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1097\/GCO.0000000000000023","article-title":"Caesarean scar pregnancy: A review of management options","volume":"25","author":"Litwicka","year":"2013","journal-title":"Curr Opin Obstet Gynecol"},{"key":"R8-20240830","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1016\/j.fertnstert.2015.12.130","article-title":"Cesarean scar pregnancy: A systematic review of treatment studies","volume":"105","author":"Birch Petersen","year":"2016","journal-title":"Fertil Steril"},{"key":"R9-20240830","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1111\/1471-0528.12165","article-title":"Caesarean section and subsequent ectopic pregnancy: A systematic review and meta-analysis","volume":"120","author":"O\u2019Neill","year":"2013","journal-title":"BJOG"},{"key":"R10-20240830","doi-asserted-by":"crossref","first-page":"e22845","DOI":"10.1097\/MD.0000000000022845","article-title":"A comparison between laparoscopy and hysteroscopy approach in treatment of cesarean scar pregnancy","volume":"99","author":"Zhang","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"R11-20240830","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1016\/j.fertnstert.2014.01.045","article-title":"Evaluation of the efficacy of laparoscopic resection for the management of exogenous cesarean scar pregnancy","volume":"101","author":"Wang","year":"2014","journal-title":"Fertil Steril"},{"key":"R12-20240830","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.jmig.2018.03.035","article-title":"Different surgical approaches to 313 cesarean scar pregnancies","volume":"26","author":"Le","year":"2019","journal-title":"J Minim Invasive Gynecol"},{"key":"R13-20240830","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.tjog.2015.03.009","article-title":"Systematic review: What is the best first-line approach for cesarean section ectopic pregnancy?","volume":"55","author":"Kanat-Pektas","year":"2016","journal-title":"Taiwanese J Obstet Gynecol"},{"key":"R14-20240830","first-page":"417","article-title":"Laparoscopic approach for a cesarean scar pregnancy","volume":"226","author":"Karampelas","year":"2022","journal-title":"Fertil Steril"},{"key":"R15-20240830","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/j.jmig.2017.05.019","article-title":"Cesarean scar pregnancies: A systematic review of treatment options","volume":"24","author":"Maheux-Lacroix","year":"2017","journal-title":"J Minim Invasive Gynecol"}],"container-title":["Advanced Biomedical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/abr.abr_345_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:59:05Z","timestamp":1787839145000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/abr.abr_345_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/abr.abr_345_22","relation":{},"ISSN":["2277-9175"],"issn-type":[{"value":"2277-9175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7]]},"assertion":[{"value":"2022-10-07","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-21","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}