Work

Risk Factors and Stratification Analysis of Cesarean Scar Pregnancy in Women with Cesarean Scar Diverticulum

Year: 2026

Type: article

Abstract: OBJECTIVE: To identify risk factors for cesarean scar pregnancy (CSP) in women with cesarean scar diverticulum (CSD) and develop a prediction model with risk stratification. METHODS: This retrospective study included 398 women with CSD and subsequent intrauterine pregnancy (82 CSP; 316 non-CSP). Clinical and sonographic variables were compared. Independent predictors from multivariable logistic regression were used to construct a nomogram. Model performance was assessed using ROC, calibration, decision curve analysis, and bootstrap validation. Risk groups were defined by tertiles of predicted probability. RESULTS: < 0.05). Independent predictors were cesarean interval (OR = 0.812), niche length (OR = 1.235), niche depth (OR = 2.129), residual myometrium thickness (OR = 0.326), log(hCG) (OR = 0.445), and progesterone (OR = 0.830). The model showed excellent discrimination (AUC = 0.970, 95% CI: 0.954-0.983). CSP incidences were 0.0%, 0.8%, and 60.9% in the low-, medium-, and high-risk groups, respectively. CONCLUSIONS: Morphological defect severity, short interpregnancy interval, and low early-pregnancy hormone levels were associated with CSP risk in women with CSD. The model may support early risk stratification and clinical management.

Source: Journal of Investigative Surgery

DOI: 10.1080/08941939.2026.2643947

Authors: Yuanhong Zhu, Jianhong Ding, Manyun Liu, Chenhao Zhu

Institutions: Hangzhou Normal University, Changsha Medical University, The First Hospital of Changsha

Language: English

Topic: Ectopic Pregnancy Diagnosis and Management

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,970