This is a case report of a first trimester cesarean scar pregnancy (CSP) evolving into a placenta accreta at term based on the ultrasound imaging. The gestational sac, initially implanted at the site of previous scar, grew into the uterine cavity as the pregnancy progressed and resulted into a viable birth complicated by placenta accreta.
Cesarean scar pregnancy is a rare form of ectopic pregnancy and is associated with increased maternal morbidity and mortality. Thus, early recognition of the salient sonographic findings is crucial because a delay could lead to a life threatening condition. Early diagnosis also gives women the option to choose between expectant management and termination of pregnancy. The exact incidence of CSP has not been determined but its incidence is on the rise in parallel with the high rate of cesarean sections. There are two types of CSP. The first type is due to the implantation of the gestational sac on the scar with progression towards the uterine cavity. In this type expectant management is justifiable since pregnancy may progress into a viable pregnancy. The second type involves growth of gestational tissues towards the bladder and abdominal cavity and is associated with uterine rupture if immediate intervention is not undertaken. In this report, we present a case of a first trimester CSP that was managed expectantly and developed into placenta accreta at term.

Human ; Female ; Adult ; Placenta Accreta ; Pregnancy Trimester, First ; Gestational Sac ; Uterine Rupture ; Pregnancy, Ectopic ; Cesarean Section ; Embryo Implantation

This is a case report of a first trimester cesarean scar pregnancy (CSP) evolving into a placenta accreta at term based on the ultrasound imaging. The gestational sac, initially implanted at the site of previous scar, grew into the uterine cavity as the pregnancy progressed and resulted into a viable birth complicated by placenta accreta.
Cesarean scar pregnancy is a rare form of ectopic pregnancy and is associated with increased maternal morbidity and mortality. Thus, early recognition of the salient sonographic findings is crucial because a delay could lead to a life threatening condition. Early diagnosis also gives women the option to choose between expectant management and termination of pregnancy. The exact incidence of CSP has not been determined but its incidence is on the rise in parallel with the high rate of cesarean sections. There are two types of CSP. The first type is due to the implantation of the gestational sac on the scar with progression towards the uterine cavity. In this type expectant management is justifiable since pregnancy may progress into a viable pregnancy. The second type involves growth of gestational tissues towards the bladder and abdominal cavity and is associated with uterine rupture if immediate intervention is not undertaken. In this report, we present a case of a first trimester CSP that was managed expectantly and developed into placenta accreta at term.

Human ; Female ; Adult ; Placenta Accreta ; Pregnancy Trimester, First ; Gestational Sac ; Uterine Rupture ; Pregnancy, Ectopic ; Cesarean Section ; Embryo Implantation

OBJECTIVE: This study aimed to determine the accuracy of internal examination and ultrasound in early stage cervical cancer. Specific objectives were to determine the accuracy of internal examination and sonography in measuring tumor size and the accuracy of sonography in detecting vaginal involvement, stromal invasion, parametrial and lymph node involvement by comparing them with the surgicopathologic findings.
MATERIALS AND METHODS: 35 patients diagnosed with early stage cervical cancer for radical hysterectomy with bilateral salpingooophorectomy were recruited. Presence of poor prognostic factors was determined by internal examination and sonography and compared with the surgicopathologic result.
RESULTS: Ultrasound and internal examination have an accuracy of 74% and 68%, respectively. Ultrasound accuracy in detecting more than one third stromal invasion is 68%, vaginal involvement is 85%, parametrial involvement is 92% and lymph node involvement is 100%.
CONCLUSION: Ultrasound can be recommended as an adjunct to internal examination in the preoperative assessment of early stage cervical cancer.

Human ; Female ; Middle Aged ; Adult ; Uterine Cervical Neoplasms ; Prognosis ; Hysterectomy ; Ultrasonography ; Vagina ; Lymph Nodes