Ectopic pregnancy in the uterine scar: a case report and literature review
DOI:
https://doi.org/10.18597/rcog.309Keywords:
ectopic pregnancy, cesarean scar pregnancy, cesarean deliveryAbstract
Introduction: ectopic pregnancy in the uterine scar occurs in 1:1,800 to 1:2,216 of pregnancies and accounts for 6.1% of ectopic pregnancies in the group of patients having had prior cesarean section. Objective: in order to review the management and diagnosis of this condition, the case of a patient having an ectopic pregnancy in the uterine scar is presented.
Case presentation: a 24-year-old patient having had a previous cesarean section consulted the Santander teaching hospital suffering from lower abdominal pain. Doppler ultrasound suggested a high probability of ectopic pregnancy in the uterine scar. Methotrexate and folinic acid therapy was thus begun. Controls were made with favorable results.
Discussion: ectopic pregnancy in the uterine scar is a long-term complication of cesarean section; it is a diagnosis which should be considered in any female having a history of previous cesarean consulting for hemorrhage during the first half of pregnancy before 10 weeks' gestation. Initial ultrasound diagnosis can be difficult; however, diagnosis can be made with repeated scans. Treatment may be medical or surgical and will mainly depend on the gestation time when diagnosis is made.
Author Biographies
Janer Sepúlveda-Agudelo
Mayra Cristancho-Solano
Carolina Parra-Meza
References
Chang J, Elam-Evans LD, Berg CJ, Herndon J, Flowers L, Seed KA, et al. Pregnancy-related mortality surveillance. United States, 1991-1999. MMWR Surveill Summ 2003;52:1-8.
Murray H, Baakdah H, Bardell T, Tulandi T. Diagnosis and treatment of ectopic pregnancy. CMAJ 2005;173:905-12.
Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies, etiology, diagnosis, and management. Obstet Gynecol 2006;107:1373-81.
Molinaro TA, Barnhart KT. Abdominal pregnancy, cesarean scar pregnancy and heterotopic pregnancy. UpToDate. May 2008.
Fylstra DL. Ectopic pregnancy within a cesarean scar: a review. Obstet Gynecol Surv 2002;57:537-43.
MolinaroTA,BarnhartKT.Ectopicpregnanciesinunusual locations. Semin Reprod Med 2007;25:123-30.
Holland MG, Bienstock JL. Recurrent ectopic pregnancy in a cesarean scar. Obstet Gynecol 2008;111:541-5.
Maymon R, Halperin R, Mendlovic S, Schneider D, Herman A. Ectopic pregnancies in a cesarean scar: review of the medical approach to an iatrogenic complication. Hum Reprod Update 2004;10:515-23.
Ash A, Smith A, Maxwell D. Caesarean scar pregnancy. BJOG 2007;114:253-63.
Condous GS. Ultrasound diagnosis of ectopic pregnancy. Semin Reprod Med 2007;25:85-91.
Godin PA, Bassil S, Donnez J. An ectopic pregnancy developing in a previous cesarean section scar. Fertil Steril 1997;67:398-400.
Lipscomb G. Medical therapy for ectopic pregnancy. Semin Reprod Med 2007;25:93-8.
Graesslin O, Dedecker F, Quereux C, Gabriel R. Conservative treatment of ectopic pregnancy in a cesarean scar. Obstet Gynecol 2005;105:869-71.
Wang CJ, Chao AS, Yuen LT, Wang CW, Soong YK, Lee CL. Endoscopic management of cesarean scar pregnancy. Fertil Steril 2006;85:494.e1-4.
Al-Sunaidi M, Tulandi T. Surgical treatment of ectopic pregnancy. Semin Reprod Med 2007;25:117-22.
Mitra AG, Harris-Owens M. Conservative medical management of advanced cervical ectopic pregnancies. Obstet Gynecol Surv 2000;55:385-9.
How to Cite
Downloads
Downloads
Published
Issue
Section
License
Copyright (c) 2016 Revista Colombiana de Obstetricia y Ginecología
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
