Successful pregnancy located in a uterine cesarean scar: A case report

Tamada, Shoko; Masuyama, Hisashi; Maki, Jota; Eguchi, Takanori; Mitsui, Takashi; Eto, Eriko; Hayata, Keiji; Hiramatsu, Yuji

doi:10.1016/j.crwh.2017.03.003

Cited by 17 publications

(11 citation statements)

References 14 publications

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“…CSP is a rare form of ectopic pregnancy, accounting for 6.1% of ectopic pregnancies and 0.15% of pregnancies in women who have previously undergone CS 3 , 4) . In most cases, CSP is diagnosed between 6 and 8 weeks of gestation because this is when the gestational sac is most clearly visible on ultrasound 5) .…”

Section: Discussionmentioning

confidence: 99%

Late-diagnosed cesarean scar pregnancy resulting in unexpected placenta accreta spectrum necessitating hysterectomy

Suzuki

Kyozuka

Fukuda

et al. 2020

FJMS

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Cesarean scar pregnancy (CSP) is a rare complication involving the implantation of the gestational sac in a cesarean delivery scar. The authors report a case of unexpected placenta accreta spectrum (PAS) caused by late diagnosed CSP, necessitating emergent hysterectomy. A 28-year-old Japanese woman with two previous cesarean deliveries presented to our hospital at 11 weeks of gestation with abnormal transvaginal ultrasound findings obtained at another hospital;however, transabdominal ultrasound revealed that the fetus was already present in the uterine cavity at this time. At 28 weeks, there was no evidence of placenta previa. The woman developed preeclampsia at 29 weeks, and a cesarean section was conducted. Intraoperative findings confirmed PAS, and hysterectomy was conducted immediately.

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Section: Discussionmentioning

confidence: 99%

Late-diagnosed cesarean scar pregnancy resulting in unexpected placenta accreta spectrum necessitating hysterectomy

Suzuki

Kyozuka

Fukuda

et al. 2020

FJMS

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“…Earlier detection and appropriate management of CSP are important. Transvaginal USG is extremely helpful in the diagnosis of CSP with the following criteria: an empty endometrial cavity and cervical canal, a gestational sac in the anterior uterine wall, and prominent trophoblastic/placental blood flow [1–3]. Magnetic resonance imaging (MRI) is superior in the assessment of pelvic structures because of improved differentiation of soft tissue, spatial resolution, and the possibility of multiplanar imaging.…”

Section: Discussionmentioning

confidence: 99%

“…Cesarean scar pregnancy (CSP) is the rarest form of ectopic pregnancy and results in implantation of the gestational sac into the fibrous tissue scar of a previous cesarean section. CSP accounts for 6.1% of ectopic pregnancies, and 0.15% of pregnancies in which the patient had previously undergone a cesarean section [1, 2]. It is considered potentially lethal, as it leads to high risks of uterine rupture.…”

Section: Introductionmentioning

confidence: 99%

Delayed diagnosis of a cesarean scar pregnancy: a case report

Cha

Seong

2019

J Med Case Reports

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Background Cesarean scar pregnancy is rare but may be related to early uterine rupture and may result in massive hemorrhage. Nowadays, most cesarean scar pregnancies are diagnosed early and can be managed properly. However, diagnoses of cesarean scar pregnancies that develop in the obstetrical area are sometimes delayed. Case presentation A 28-year-old Asian woman visited our institution because of suspected cesarean scar pregnancy. Ultrasonography and computed tomography confirmed a cesarean scar pregnancy with a live fetus with a crown-rump length of 4.83 cm, corresponding to 11 weeks 6 days of gestation. Initially, we injected 50 mg of methotrexate in the amniotic sac under transabdominal ultrasonographic guidance. However, fetal cardiac activity was still observed 2 days later. We decided to perform open laparotomy because of the possibility of massive bleeding. The gestational sac was removed, as well as most of the trophoblastic tissues that were adherent and invading the wall of the lower uterine segment. She was discharged in good condition 5 days after the operation. Conclusions Despite the popular use of ultrasonography in prenatal care, diagnosis of cesarean scar pregnancy is still delayed. Surgical treatment with local methotrexate injection could be an option for the management of advanced cesarean scar pregnancy.

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“…In the first type, the implanted gestational sac grows towards the cervicoisthmic space or the uterine cavity. Such pregnancy might proceed to term with a viable fetus but it has an increased risk of life-threatening massive postpartum hemorrhage from the implantation site [7]. In the second type, the deeply implanted gestational sac grows towards the serosal surface of the uterine wall.…”

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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Successful pregnancy located in a uterine cesarean scar: A case report

Cited by 17 publications

References 14 publications

Late-diagnosed cesarean scar pregnancy resulting in unexpected placenta accreta spectrum necessitating hysterectomy

Late-diagnosed cesarean scar pregnancy resulting in unexpected placenta accreta spectrum necessitating hysterectomy

Delayed diagnosis of a cesarean scar pregnancy: a case report

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

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