Study on clinical, paraclinical characteristics and outcomes of surgical treatment for cesarean scar pregnancy at Da Nang Hospital for Women and Children

Objective(s): To describe the clinical and paraclinical characteristics and evaluate the surgical treatment outcomes of cesarean scar pregnancy (CSP) at Da Nang Hospital for Women and Children. Methods: A cross-sectional descriptive study was conducted on 133 patients with CSP who underwent surgical treatment at Da Nang Hospital for Women and Children from January 2024 to January 2026. Results: The mean age of the patients was 35.7 ± 4.6 years. Amenorrhea was the most common clinical symptom (66.2%), followed by lower abdominal pain (52.6%) and vaginal bleeding (42.9%); 10.5% of the patients were asymptomatic, and 0.8% presented with severe hemorrhage. On transvaginal ultrasound, the gestational age at diagnosis was predominantly between 6 and < 8 weeks (52.6%). Type I (endogenic) CSP was prevalent (65.4%), while Type II (exogenic) CSP accounted for 34.6%. Hypervascularity at the cesarean scar site was recorded in 42.9% of cases. Pre-treatment serum β-hCG levels were mainly concentrated in the range of 10,000 - 50,000 mIU/mL (49.5%), with levels > 100,000 mIU/mL accounting for 5.6%. Ultrasound-guided suction curettage was the predominant surgical treatment modality (94.7%), yielding an overall success rate of 96.0%. The treatment success rate reached 100% in cases exhibiting Type I (endogenic) CSP and an absence of hypervascularity on ultrasound. Conclusion: Cesarean scar pregnancy (CSP) presents with non-specific clinical symptoms. Ultrasound-guided suction curettage is the primary surgical treatment option and is highly effective. However, Type II (exogenic) CSP and the presence of hypervascularity at the scar site serve as core prognostic factors that significantly increase the risk of treatment failure.