Surgical Management of the Cesarean Scar Ectopic Pregnancy: A Case Report

Nankali, Anisodowleh; Ataee, Mina; Shahlazadeh, Haleh; Daeichin, Sara

doi:10.1155/2013/525187

Cited by 13 publications

(18 citation statements)

References 19 publications

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“…It can be identified by the presence of fluid within the incision site or filling defect (niche) which is a triangular anechoic structure at the site of scar. 4,7 These patients should be watched for caesarean scar ectopic pregnancy in the future. Several types of conservative treatment have been proposed.…”

Section: Discussionmentioning

confidence: 99%

“…It has an estimated incidence of 1:1800 -2200 pregnancies. 3,4 The overall incidence is however thought to be increasing, representing up to 6% of the ectopic pregnancies. Recurrence rate is 5%.…”

Section: Introductionmentioning

confidence: 99%

“…Excision of the sac through laparoscopy or laparotomy which includes excision of the scar site ectopic and closure of the scar. 4,7 Bilateral hypogastric artery ligations followed by dilatation and evacuation under laparoscopic guidance may be another alternative. 9,7 In cases of massive bleed emergency hysterectomy is lifesaving.…”

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confidence: 99%

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Caesarean scar ectopic pregnancy

Devi

Sweta

Devi

2018

Int J Reprod Contracept Obstet Gynecol

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Ectopic pregnancy is a common cause of mortality and morbidity among the women of reproductive age group. Tubal pregnancy is the commonest. It can occur in cervix, ovaries, previous caesarean scar, interstitial portion of the tube and abdominal cavity. Here we report a case of caesarean scar ectopic pregnancy which was managed conservatively. 31 yrs old gravid 3 previous 1 LSCS and 1 tubal ectopic come for antenatal consultation at 35 days of gestation. UPT was Positive. USG showed no evidence of intra uterine sac. Repeat scan after 10 days showed a gestational sac at the lower uterine segment scar. Hence it was decided for conservative management, injection methotrexate 50 mgm X 2 doses given. This was followed by misoprost vaginal insertion. Since patient did not expel the sac, injection PG F2 alpha 125 mg x 2 doses were given. Patient expelled the products of conception partially. This was followed by hysteroscopic guided evacuation.Caesarean scar ectopic was reported in 1978. Early diagnosis is by TV USG / MRI. Early ectopic can be treated medically. In delayed diagnosis, laparoscopic excision of the scar has to be done. In rupture of the scar site ectopic pregnancy laparotomy is indicated. In the event of heavy bleeding, hysterectomy has to be done. After conservative management and excision of the scar, fertility is not altered. Caesarean section scar pregnancy is a rare form of ectopic pregnancy which can lead to life threatening complications leading to mortality and morbidity. Treatment has to be individualized according to the gestational age, haemodynamic stability and desire for future fertility.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Caesarean scar ectopic pregnancy

Devi

Sweta

Devi

2018

Int J Reprod Contracept Obstet Gynecol

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“…Similar case was reported by Nankali et al and Singh et al and the same treatment approach was adopted. 7,8 …”

Section: Discussionmentioning

confidence: 99%

Ruptured caesarean scar ectopic pregnancy: a rare case report

Jain¹,

Chaudhary²,

Jain³

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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“…A caesarean scar pregnancy (CSP), which is considered a type of ectopic pregnancy, occurs when the embryo is implanted in the myometrium at the site of a previous caesarean section (CS) scar. 1 The exact incidence of CSP is unknown, as very few cases have been reported in the literature. 2 The first case was described in 1978 by Larsen and Solomon and its incidence is increasing due to the rising rates of caesarean section and the higher accuracy of ultrasonography for diagnosis.…”

Section: Introductionmentioning

confidence: 99%