Abstract
A cesarean scar ectopic pregnancy (CSEP) is a rare and life-threatening condition with a prevalence of one over 3, 000 pregnancies. If not promptly diagnosed, patients may undergo fatal results. There is no consensus for the management of this type of ectopic pregnancy. The authors present a series of three cases involving different clinical scenarios for the management of cesarean ectopic pregnancy. The diagnosis was made using laboratory results, ultrasound images, and surgery. Treatment was performed using different techniques according to this hospital’s capabilities; from surgery to methotrexate use, all with satisfactory results. The authors discuss the clinical significance and differential diagnosis of CSEP in the setting of a second level reference hospital.
Highlights
A cesarean scar ectopic pregnancy (CSEP) is a rare and dangerous condition that occurs when the blastocyst implantation abnormally locates between the myometrium and the fibrous scar tissue of a cesarean section (c-section) [1, 2]
Ectopic pregnancy treatment was limited to surgery, being either hysterectomy, excision of the pregnancy located in the scarred uterus or dilation and curettage
The use of systemic methotrexate is a conservative option in selected cases and treatments like uterine artery embolization or endoscopic CSEP removal in combination, even along with the administration of Revised manuscript accepted for publication November 27, 2017
Summary
Summary A cesarean scar ectopic pregnancy (CSEP) is a rare and life-threatening condition with a prevalence of one over 3,000 pregnancies. There is no consensus for the management of this type of ectopic pregnancy. The authors present a series of three cases involving different clinical scenarios for the management of cesarean ectopic pregnancy. The diagnosis was made using laboratory results, ultrasound images, and surgery. Treatment was performed using different techniques according to this hospital’s capabilities; from surgery to methotrexate use, all with satisfactory results. The authors discuss the clinical significance and differential diagnosis of CSEP in the setting of a second level reference hospital
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