Case Report:Laparoscopic management of an ectopic pregnancy in a previous Caesarean section scar

Lee, Chyi Long; Wang, Chin Jung; Chao, Angel; Yen, Chih‐Feng; Soong, Yung Kuei

doi:10.1093/humrep/14.5.1234

Cited by 149 publications

(108 citation statements)

References 7 publications

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“…Successful laparoscopic resection of scar pregnancy was first performed by Lee et al [14] Principles of laparoscopic surgery are: scar pregnancy is excised and removed in endobag, bleeding is minimized by local injection of vasopressin, haemostasis is achieved by bipolar diathermy, and the uterine defect is closed by endoscopic suturing. Laparoscopic approach is more justifiable when scar pregnancy is deeply implanted and grows towards abdominal cavity and bladder.…”

Section: Managementmentioning

confidence: 99%

Scar Ectopic Pregnancy

Patel

2015

J Obstet Gynecol India

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Scar ectopic pregnancy is the rarest form of ectopic pregnancy and has been increasingly diagnosed all over the world. This is a life-threatening form of abnormal implantation of embryo within the myometrium and fibrous tissues in a previous scar on the uterus, especially following caesarean section. With the increasing rate of caesarean section, there is a substantial increase in this condition with better understanding of this disease. The early and accurate diagnosis with timely management can prevent pregnancy complications such as haemorrhage, uterine rupture and can preserve fertility.

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Section: Managementmentioning

confidence: 99%

Scar Ectopic Pregnancy

Patel

2015

J Obstet Gynecol India

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“…This is still the preferred option in haemodynamically unstable women when uterine rupture is confirmed or suspected. Laparoscopic removal was later described in 1999 by Lee et al [9] and is most suitable for deeply implanted CSEPs growing toward the abdominal cavity and bladder. For CSEPs growing inwards toward the uterine cavity, hysteroscopic evacuation is most appropriate.…”

Section: Discussionmentioning

confidence: 99%

Caesarean Scar Ectopic Pregnancies—Case Series from a District General Hospital

Akhanoba¹,

Awala²,

Tony³

2017

OJOG

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Caesarean Scar Ectopic Pregnancy (CSEP) is a rare, but potentially catastrophic complication of a previous Caesarean Section (CS) birth. This is a review of 5 cases of CSEP managed in our Early Pregnancy Unit at Watford General Hospital within a 10-month period. Two patients had only one previous CS, whilst 2 had two and the last had 3 previous CS. All our patients presented within the first trimester of pregnancy (range 6 to 11 weeks' gestation) with light vaginal bleeding; 4 of them had associated mild to moderate abdominal pain. All were diagnosed using transvaginal ultrasound scan. Three of our patients were managed surgically by Suction Evacuation under Ultrasound guidance and insertion of a Foley's catheter prophylactically for tamponade in order to reduce blood loss both intra-and post-operatively. One of our patients had a heterotopic pregnancy with a viable intrauterine pregnancy and a live CSEP. She declined any intervention so she was managed conservatively with weekly Consultant appointments and scans. There was a subsequent demise of the CSEP and she continued with a singleton pregnancy. None of our patients were managed medically. There is no absolute consensus on diagnostic criteria and there is no standard management protocol so each woman should be given all the available information and the opportunity to decide on the management of her pregnancy. The risk of a CSEP in a subsequent pregnancy should be part of the consent process for CS.

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“…Furthermore, other authors [22] suggested that dilatation and curettage is contraindicated for this kind of ectopic pregnancy, since they are considered as cause of uterine perforation and intractable bleeding and consequently, hysterectomy.…”

Section: Discussionmentioning

confidence: 99%