Management of cesarean scar pregnancy with suction curettage: a report of four cases and review of the literature

Objective Implantation of the pregnancy in a cesarean scar is a rare condition named ; Cesarean scar pregnancy (CSP). Maternal complications can be prevented with the early diagnosis and an appropriate management .It is a Prospective clinical study to evaluate the efficacy and success rate of single dose use of methotrexate (MTX) followed by dilation and suction (D&S) regimen in management of women with cesarean scar pregnancy (CSP) . Methods 50mg of MTX in the form of a single dose Intramuscular injection then cervical dilatation and suction aspiration with a Karman cannula(D&S) under guidance of ultrasound after 48 preeceeded by vaginal misoprostol 2 tablet (200 mg) 4 hours ago. Results The mean gestational age at diagnosis was (8.5±1.6 ) and The mean level of serum b-human chorionic gonadotropin was (7424±2.560 ) and The mean gestational age of pregnancy was (8.5±1.6 ) .88.7% is the successive rate without complication need intervention, 2 (5.7%) patients needed intrauterine Foley's catheter for 24 hours as a mechanical hemostasis . 2 (5.7 %) had laparotomy with wedge resection of the gestational sac lesion and successful repair of the uterine defect and one (2.8 %)underwent subtotal hysterectomy. Conclusion: Systemic single dose MTX injection followed by D&S is an effective and harmless management for CSP. Nevertheless more studies are required to prove the efficiency, safety, and reproductive outcome of variant modalities in treatment of CSP.

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Suction Curettage as First Line Therapy for Cesarean Scar Pregnancy

Journal of Minimally Invasive Gynecology ◽

10.1016/j.jmig.2017.08.623 ◽

2017 ◽

Vol 24 (7) ◽

pp. S196

Author(s):

S. Czeiger ◽

G. Oelsner

Keyword(s):

First Line ◽

Cesarean Scar Pregnancy ◽

Cesarean Scar ◽

First Line Therapy ◽

Line Therapy ◽

Suction Curettage

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Single Dose of Methotrexate Therapy Followed By Suction Curettage for Management of Cesarean Scar Pregnancy

Obstetrics Gynecology and Reproductive Sciences ◽

10.31579/2578-8965/028. ◽

2019 ◽

Vol 3 (3) ◽

pp. 01-05

Author(s):

Hend Saleh

Keyword(s):

Single Dose ◽

Gestational Age ◽

Wedge Resection ◽

Rare Condition ◽

Prospective Clinical Study ◽

Maternal Complications ◽

Cesarean Scar Pregnancy ◽

Cesarean Scar ◽

Suction Curettage ◽

The Mean

Objective Implantation of the pregnancy in a cesarean scar is a rare condition named ; Cesarean scar pregnancy (CSP). Maternal complications can be prevented with the early diagnosis and an appropriate management .It is a Prospective clinical study to evaluate the efficacy and success rate of single dose use of methotrexate (MTX) followed by dilation and suction (D&S) regimen in management of women with cesarean scar pregnancy (CSP) . Methods 50mg of MTX in the form of a single dose Intramuscular injection then cervical dilatation and suction aspiration with a Karman cannula(D&S) under guidance of ultrasound after 48 preeceeded by vaginal misoprostol 2 tablet (200 mg) 4 hours ago. Results The mean gestational age at diagnosis was (8.5±1.6 ) and The mean level of serum b-human chorionic gonadotropin was (7424±2.560 ) and The mean gestational age of pregnancy was (8.5±1.6 ) .88.7% is the successive rate without complication need intervention, 2 (5.7%) patients needed intrauterine Foley's catheter for 24 hours as a mechanical hemostasis . 2 (5.7 %) had laparotomy with wedge resection of the gestational sac lesion and successful repair of the uterine defect and one (2.8 %)underwent subtotal hysterectomy. Conclusion: Systemic single dose MTX injection followed by D&S is an effective and harmless management for CSP. Nevertheless more studies are required to prove the efficiency, safety, and reproductive outcome of variant modalities in treatment of CSP.

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Cesarean Scar Ectopic Pregnancy: Case Report and Review of the Literature

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1387 ◽

2016 ◽

Vol 8 (1) ◽

pp. 66-68

Author(s):

Thankam Varma ◽

Shashidhar Boraiah

Keyword(s):

Case Report ◽

Ectopic Pregnancy ◽

Tertiary Care ◽

Review Of The Literature ◽

Artery Embolization ◽

Cesarean Scar Pregnancy ◽

Rare Type ◽

Cesarean Scar ◽

Maternal Morbidity And Mortality ◽

Tertiary Care Hospitals

ABSTRACT Cesarean scar ectopic pregnancy is becoming increasingly common in tertiary care hospitals. Cesarean scar pregnancy is a rare type of ectopic pregnancy associated with complications, such as uterine rupture, uncontrollable bleeding which may lead to hysterectomy and increased maternal morbidity and mortality and subsequent infertility. Options available for treatment, such as dilatation and curettage, excision of trophoblastic tissues using laparotomy or laparoscopy, systemically administered methotrexate, and more recently uterine artery embolization. We report two such cases between 2012 and 2013 managed conservatively. How to cite this article Boraiah S, Varma T, Shankar K. Cesarean Scar Ectopic Pregnancy: Case Report and Review of the Literature. J South Asian Feder Obst Gynae 2016;8(1):66-68.

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