Onur KARAASLAN, Erkan ŞİMŞEK, Erbil KARAMAN, Metin AYGAR, Ersin ONAT, Latif HACIOĞLU, Çağrı ATEŞ, Hanım Güler ŞAHİN, Gürcan TÜRKYILMAZ, Gülcan Karataş GEZEN
Van Medical Journal - 2026;33(4):415-421
Introduction: Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy that carries a substantial risk of maternal morbidity. Because identifying which patients respond well to therapy is central to better clinical care, we set out to describe the demographic and clinical profile of women managed for CSP at our center and to look for factors tied to whether treatment succeeded. Methods: We carried out a retrospective cohort study of 172 women with a confirmed diagnosis of cesarean scar pregnancy. Baseline demographic and obstetric details were recorded for each patient, who was then grouped according to whether her first-line treatment ultimately worked. Because first-line treatment was individualized rather than randomized, we also compared the baseline characteristics of the four primary treatment groups. Univariate and multivariate logistic regression were used to test which clinical variables were related to treatment success. Results: Treatment was successful in 153 women (89.0%) and failed in 19 (11.0%). Women whose treatment failed were diagnosed at a later gestational age than those treated successfully (7.4 +/- 1.3 vs. 6.8 +/- 1.4 weeks, p = 0.023). Age, gravidity, parity, and the presence of fetal cardiac activity did not differ between the two groups. The first-line treatment used was closely related to gestational age and to fetal cardiac activity (both p <= 0.002), which shows that treatment was chosen according to the clinical severity of the presentation. On multivariate analysis, none of gestational age at diagnosis, fetal cardiac activity, the number of prior cesarean sections, or the treatment approach was independently linked to treatment success. Conclusion: When CSP is recognized early and managed appropriately, treatment usually succeeds. A later gestational age at diagnosis was associated with failure on univariate testing, but no factor remained an independent predictor of success after multivariate adjustment; the link between early diagnosis and success should therefore be read as a hypothesis-generating observation rather than a proven independent effect.
