Abstract
OBJECTIVE: To compare complication rates between suction dilation and curettage (D&C) and nonsuction management of cesarean scar ectopic pregnancy. METHODS: We performed a single-center, retrospective chart review of cesarean scar ectopic pregnancy management from January 2008 to March 2025. Nonsuction management included medical and other surgical treatments. Our primary outcome was a 10-item complication composite. Secondary outcomes included complication rates associated with misdiagnosis and a gestational age subanalysis. We compared outcomes using χ(2) tests. RESULTS: We included 77 patients with cesarean scar ectopic pregnancies. Forty-four (57.1%) underwent nonsuction management, and 33 (42.9%) underwent suction D&C. Complication rates were higher for nonsuction management compared with suction D&C (17/44 [38.6%] vs 5/33 [15.2%], respectively; risk ratio (RR) 2.6, 95% CI, 1.0-6.2). Initial misdiagnosis of cesarean scar ectopic pregnancy was associated with higher complication rates (11/22 [50.0%]; RR 2.5, 95% CI, 1.3-4.9). CONCLUSION: Nonsuction management resulted in 2.5 times more complications than suction D&C for cesarean scar ectopic pregnancy.