Cesarean scar ectopic pregnancy: Case report☆

Brancazio, Sophia; Saramago, Israel; Goodnight, William; McGinty, Katrina

doi:10.1016/j.radcr.2018.12.001

Cited by 13 publications

(18 citation statements)

References 17 publications

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“…A high clinical suspicion of scar ectopic is required in all early pregnancies with previous caesarean delivery presenting with painless vaginal bleeding. 1 The presence of cardiac activity is a poor prognostic factor due to the increased risk of complications. Uterine rupture was seen in 9.9% of scar ectopic pregnancy with cardiac activity.…”

Section: Discussionmentioning

confidence: 99%

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A rare case of caesarean scar ectopic pregnancy: a case report

Hiremath¹,

Anandabaskar²,

Arthi³

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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Scar ectopic pregnancy is a condition where the gestational sac implants into the previous caesarean scar site. Although it is a rare entity, its incidence is increasing due to rising rates of caesarean deliveries. Here authors report a case of caesarean scar ectopic pregnancy managed by laparotomy with caesarean scar ectopic excision following failed medical management. The patient recovered without any intraoperative or postoperative complications. An early diagnosis and management are vital in preventing maternal morbidity and mortality.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Ectopic pregnancy contributes to nearly 6% of pregnancy related deaths. 1 Scar ectopic pregnancy is a condition where the gestational sac implants into the previous caesarean scar site. 2 The incidence of scar ectopic pregnancy is 1 in 2000.…”

Section: Introductionmentioning

confidence: 99%

A rare case of caesarean scar ectopic pregnancy: a case report

Hiremath¹,

Anandabaskar²,

Arthi³

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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show abstract

“…The first case of scar ectopic pregnancy was reported by Larsen and Solomon in 1978 [4]. Although considered a rare type of pregnancy, the incidence of cesarean scar ectopic pregnancy is increasing owing to the increasing rates of cesarean deliveries worldwide [5, 6].…”

Section: Discussionmentioning

confidence: 99%

“…In our case, the patient had four previous cesarean section deliveries which predisposed her for ectopic pregnancy. Interestingly, the risk of cesarean scar pregnancy appears to be unrelated to the number of previous cesarean deliveries [5, 6].…”

Section: Discussionmentioning

confidence: 99%

Cesarean Scar – Unusual Site of Ectopic Pregnancy: A Case Report

Gadeeb

Matrouk

et al. 2019

Cureus

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Ectopic pregnancy is a leading cause of maternal mortality in the first trimester. It may occur in different anatomic locations with fallopian tube being the most frequent. Cesarean-scar ectopic pregnancy is one of the rarest ectopic pregnancies. We report the case of a 44-year-old woman, gravida 5 para 4, who attended the antenatal clinic after her pregnancy was confirmed by positive urine testing. She underwent transvaginal ultrasound examination which identified the gestational sac with fetal pole and cardiac activity located in the anterior part of the lower uterine segment with empty uterine cavity. Magnetic resonance imaging (MRI) scan had confirmed the diagnosis of cesarean scar ectopic pregnancy. After through discussion on the management options, the patient was treated with intra-gestational sac injection of methotrexate. Four days after the procedure, she developed profuse vaginal bleeding and her hemoglobin showed a drop of 4.9 g/dL. She underwent emergency laparotomy with excision of the ectopic pregnancy. The patient tolerated the procedure well without complications. The serum β-human chorionic gonadotropin level was undetectable on the 35 th day after the methotrexate injection. Caesarean scar pregnancy is an unusual form of ectopic pregnancy. However, clinicians should have a high index of suspicion for this condition as it may result in serious complications, unless promptly managed. MRI is recommended particularly when transvaginal ultrasound scan is inconclusive.

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“…Level of β-HCG has an important reference value before and after the treatment of CSP. Several studies suggested better efficacy with Medical treatment in those with a Beta HCG of <5000miu/ml [15,16]. However, it can be considered in patients with higher levels of Beta HCG as well.…”

Section: Figurementioning

confidence: 99%

Live Cesarean Scar Pregnancy: A Case Report

Dua¹,

Amin²,

Amin³

2020

CROGR

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Introduction: The overall incidence of Cesarean scar pregnancy is increasing due to Cesarean rates. This life-threatening condition has been historically managed in various ways as no single modality is reliable enough. We report this case of live CSP managed initially with Fetocide followed by Methotrexate but requiring Surgical management later on. Presentation: A 32 years old para 5 with four previous Cesarean sections was diagnosed with live CSP. HCG level was 76,619. The initial management was fetocide with KCL followed by Methotrexate. The treatment was considered successful in view of appropriate reduction in serum HCG levels. The woman required surgical management 10 weeks after the initial management, but the blood loss was minimal. Discussion: A CSP may be asymptomatic or present with non-specific symptoms. The rate of initial misdiagnosis is as high as 76%. TVUSS enables correct CSP diagnosis and implementation of minimally invasive effective treatment. HCG levels can affect the overall outcome, but medical management can be considered even with high HCG levels. Conclusion: CSP is a life-threatening condition, therefore timely diagnosis and appropriate management is crucial. Medical management can be considered in most cases even with high HCG, but management has to be tailored according to the patient. Close follow up of patient after Medical treatment is important as they may require further intervention.

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Cesarean scar ectopic pregnancy: Case report☆

Cited by 13 publications

References 17 publications

A rare case of caesarean scar ectopic pregnancy: a case report

A rare case of caesarean scar ectopic pregnancy: a case report

Cesarean Scar – Unusual Site of Ectopic Pregnancy: A Case Report

Live Cesarean Scar Pregnancy: A Case Report

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