Operative Therapy for Heterotopic Scar Pregnancy and Successful Birth of the Intrauterine Foetus – Case Report and Review of the Literature

Armbrust, Robert; Krätschell, Robert W.; Henrich, Wolfgang; David, Matthias

doi:10.1055/s-0035-1545918

Cited by 12 publications

(6 citation statements)

References 17 publications

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“…Therefore, in the present study, we conducted a search and review of the literature pertaining to HCSP. To the best of our knowledge, a total of 23 cases of HCSP have been reported in the English literature [2, 4, 10, 12–26], and the results are summarized in Additional file 1: Table S1. The reported treatments included conservative management, fetal reduction by potassium chloride, laparoscopic excision, aspiration of embryonic or ectopic gestational sac, hysteroscopy with directed evacuation, injection of a mixture of MTX and KCl, or laparotomic excision.…”

Section: Discussionmentioning

confidence: 99%

“…Wang et al reported hysteroscopic management of heterotopic cesarean scar pregnancy under ultrasound guidance at 7 weeks of gestation, with the baby delivered at 39 weeks of pregnancy [17]. Armbrust et al successfully excised a HSP by laparotomy at 7 weeks of gestation, with a subsequent uncomplicated cesarean section and delivery of a healthy baby at 37 weeks of pregnancy [26]. …”

Section: Discussionmentioning

confidence: 99%

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Successful selective reduction of a heterotopic cesarean scar pregnancy in the second trimester: a case report and review of the literature

Luo

Zhao

et al. 2016

BMC Pregnancy Childbirth

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BackgroundHeterotopic cesarean scar pregnancy is a cesarean scar pregnancy combined with an intrauterine pregnancy that predisposes a woman to life-threatening complications such as uterine rupture and massive bleeding. Preservation of the intrauterine pregnancy in heterotopic cesarean scar pregnancy is a great challenge.Case presentationWe report a case of a 33-year-old woman with heterotopic cesarean scar pregnancy after IVF-embryo transfer (ET). Expectant management was carried out with early diagnosis of heterotopic cesarean scar pregnancy (HCSP), and selective fetal reduction of cesarean scar pregnancy (CSP) was performed by ultrasound-guided intrathoracic injection of potassium chloride (KCl) at 16 + 4 weeks of gestation due to aggravation of CSP. Preservation of the intrauterine pregnancy was successful and a healthy baby was delivered by cesarean section at 37 + 6 weeks of gestation.ConclusionsHeterotopic cesarean scar pregnancy is an extremely rare form of heterotopic pregnancy. Patients should be appropriately counseled regarding the different treatment options available. An ultrasound-guided injection of potassium chloride may constitute a safe, minimally invasive and reliable way to terminate the heterotopic gestation and preserve the intrauterine pregnancy. Intensive management should be performed during the ongoing pregnancy and cesarean section.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1171-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Successful selective reduction of a heterotopic cesarean scar pregnancy in the second trimester: a case report and review of the literature

Luo

Zhao

et al. 2016

BMC Pregnancy Childbirth

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“…The extrauterine pregnancy may be located in the fallopian tube, cervix, caesarean section scar. The latter one is expected to increase alongside with the increasing rate of caesarean sections [56,57].…”

Section: Heterotopic Pregnancymentioning

confidence: 99%

Diagnostic Methods of Ectopic Pregnancy and Early Pregnancy Loss: a Review of the Literature

Hamza¹,

Meyberg-Solomayer²,

Juhasz‐Böss³

et al. 2016

Geburtshilfe Frauenheilkd

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This review article presents recent evidence on early pregnancy loss and ectopic pregnancy. In the light of recent evidence, the ?-hCG discriminatory zone may be extended in clinically stable cases without evidence of bleeding. A possible cut-off is 4300?mIU/ml, which corresponds to when a sonographer should detect an intrauterine pregnancy. Embryonic demise can be confirmed when a transvaginal ultrasound finding shows no heartbeat in an embryo of more than 7?mm CRL, no embryo in a gestational sac having a mean sac diameter of more than 25?mm, or no appearance of an embryo within 7?10 days after the primary examination. These are considered definitive signs of embryonic demise. Suggestive signs of embryonic demise require closer monitoring of the pregnancy.

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“…However, morbidly adherent placenta and massive bleeding during ongoing pregnancy are common obstetric complications[ 5 , 9 ]. Surgical management has been preferred by some authors[ 6 , 10 , 11 ]. Because of the rarity of HCSP, no universal treatment guidelines have been established when IUP is desired to be preserved.…”

Section: Introductionmentioning

confidence: 99%

Management of heterotopic cesarean scar pregnancy with preservation of intrauterine pregnancy: A case report

Chen

Zhou

Qian

et al. 2021

WJCC

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BACKGROUND Heterotopic cesarean scar pregnancy (HCSP) is very rare and has a high risk of massive uterine bleeding. Preservation of concurrent intrauterine pregnancy (IUP) is one of the great challenges in the management of HCSP. No universal treatment protocol has been established when IUP is desired to be preserved. CASE SUMMARY We report a case of HCSP at 8 + wk gestation in a 34-year-old woman with stable hemodynamics. A two-step intervention was applied. Selective embryo aspiration was performed first, and surgical removal of ectopic gestational tissue by suction and curettage was performed 2 d later. Both steps were performed under ultrasound guidance. The patient had an uneventful course, and a healthy baby was delivered at 34 +6 wk gestation. CONCLUSION Selective embryo aspiration followed by suction and curettage was successful in the preservation of IUP in the management of HCSP. This approach is an alternative option for HCSP in the first trimester when the IUP is desired to be preserved.

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Operative Therapy for Heterotopic Scar Pregnancy and Successful Birth of the Intrauterine Foetus – Case Report and Review of the Literature

Cited by 12 publications

References 17 publications

Successful selective reduction of a heterotopic cesarean scar pregnancy in the second trimester: a case report and review of the literature

Successful selective reduction of a heterotopic cesarean scar pregnancy in the second trimester: a case report and review of the literature

Diagnostic Methods of Ectopic Pregnancy and Early Pregnancy Loss: a Review of the Literature

Management of heterotopic cesarean scar pregnancy with preservation of intrauterine pregnancy: A case report

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