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Misdiagnosis analysis of uterine scar pregnancy after cesarean section

  • Authors:
    • Xiaoling Xin
    • Wenyan Cai
    • Yiru Hou
    • Kaili Wei
    • Xuan Peng
    • Ruirui Ma
    • Qian Sun
    • Jiaxi Yao
  • View Affiliations / Copyright

    Affiliations: Department of Obstetrics and Gynecology, 940th Hospital of The Joint Logistics Support Force of The Chinese People's Liberation Army, Lanzhou, Gansu 730050, P.R. China, Department of Clinical Medicine, Medical College, Hexi University, Zhangye, Gansu 734000, P.R. China, Institute of Urology, Hexi University, Zhangye, Gansu 734000, P.R. China
    Copyright: © Xin et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 230
    |
    Published online on: September 25, 2025
       https://doi.org/10.3892/etm.2025.12980
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Abstract

Misdiagnosed uterine scar pregnancy after cesarean section can lead to serious consequences such as uterine rupture and hemorrhagic shock. The present study aimed to analyze the causes and treatment outcomes of misdiagnosed uterine scar pregnancy after cesarean section. A retrospective analysis was conducted on the clinical data of seven patients with cesarean scar pregnancy from the Department of Obstetrics and Gynecology at the 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army (Gansu, China) in order to analyze the causes of misdiagnosis and explore effective treatment methods. All seven cases were misdiagnosed as intrauterine pregnancy, wherein three were threatened with miscarriage of early pregnancy and four with embryonic arrest. In total, three patients experienced bleeding reaching volumes of 800‑1,400 ml (cases 1, 4 and 6). After active bilateral uterine artery embolization (cases 1, 2, 4, 5 and 6), a combination of mifepristone and methotrexate was administered, and the patients' bleeding stopped after embolization treatment. These observations suggest that the use of medications or interventional embolization (cases 1, 2, 4, 5 and 6) followed by ultrasound‑guided curettage can yield positive benefits and allow for full patient recovery.
View Figures

Figure 1

Ultrasound images of three patients'
incomplete abortion (red arrow). (A) Case 2, (B) case 3 and (C)
case 4.

Figure 2

Postoperative pathological specimens
(case 3 uterine cesarean scar pregnancy resection) showing villous
tissue and trophoblast cells (red arrow).

Figure 3

Scar incision (red arrow) in the
uterine cavity and gestational sac without fetal heart (yellow
arrow) are noted in the ultrasound image (case 6).

Figure 4

Postoperative pathological specimens
(case 6 uterine cesarean scar pregnancy resection) revealing
chorionic tissue and trophoblast cells (red arrows).

Figure 5

Misdiagnosis of embryonic arrest in
three patients according to ultrasound (red arrow: Echo in the
uterine cavity). (A) Case 1, (B) case 5 and (C) case 7.
View References

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Copy and paste a formatted citation
Spandidos Publications style
Xin X, Cai W, Hou Y, Wei K, Peng X, Ma R, Sun Q and Yao J: Misdiagnosis analysis of uterine scar pregnancy after cesarean section. Exp Ther Med 30: 230, 2025.
APA
Xin, X., Cai, W., Hou, Y., Wei, K., Peng, X., Ma, R. ... Yao, J. (2025). Misdiagnosis analysis of uterine scar pregnancy after cesarean section. Experimental and Therapeutic Medicine, 30, 230. https://doi.org/10.3892/etm.2025.12980
MLA
Xin, X., Cai, W., Hou, Y., Wei, K., Peng, X., Ma, R., Sun, Q., Yao, J."Misdiagnosis analysis of uterine scar pregnancy after cesarean section". Experimental and Therapeutic Medicine 30.6 (2025): 230.
Chicago
Xin, X., Cai, W., Hou, Y., Wei, K., Peng, X., Ma, R., Sun, Q., Yao, J."Misdiagnosis analysis of uterine scar pregnancy after cesarean section". Experimental and Therapeutic Medicine 30, no. 6 (2025): 230. https://doi.org/10.3892/etm.2025.12980
Copy and paste a formatted citation
x
Spandidos Publications style
Xin X, Cai W, Hou Y, Wei K, Peng X, Ma R, Sun Q and Yao J: Misdiagnosis analysis of uterine scar pregnancy after cesarean section. Exp Ther Med 30: 230, 2025.
APA
Xin, X., Cai, W., Hou, Y., Wei, K., Peng, X., Ma, R. ... Yao, J. (2025). Misdiagnosis analysis of uterine scar pregnancy after cesarean section. Experimental and Therapeutic Medicine, 30, 230. https://doi.org/10.3892/etm.2025.12980
MLA
Xin, X., Cai, W., Hou, Y., Wei, K., Peng, X., Ma, R., Sun, Q., Yao, J."Misdiagnosis analysis of uterine scar pregnancy after cesarean section". Experimental and Therapeutic Medicine 30.6 (2025): 230.
Chicago
Xin, X., Cai, W., Hou, Y., Wei, K., Peng, X., Ma, R., Sun, Q., Yao, J."Misdiagnosis analysis of uterine scar pregnancy after cesarean section". Experimental and Therapeutic Medicine 30, no. 6 (2025): 230. https://doi.org/10.3892/etm.2025.12980
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