Abstract
Cesarean scar pregnancy is a rare type of ectopic pregnancy associated with severe complications such as uterine rupture, uncontrollable bleeding which may lead to hysterectomy, and definitive infertility. Many therapeutic options are available such as Dilatation & Curetage, excision of trophoblastic tissues using either laparotomy or laparoscopy, systemically administered Methotrexate, and more recently uterine artery embolization. The use of Methotrexate sometimes required laparotomy later because of severe hemorrhage. Through this paper, we demonstrated that viable cesarean scar pregnancy can be managed safely by systemically delivered Methotrexate at the cost of a prolonged followup.
Highlights
Cesarean scar pregnancy (CSP) is an ectopic pregnancy implanted in the myometrium at the site of a previous cesarean section scar
Several types of conservative treatment have been used: dilatation and curettage, excision of trophoblastic tissues [2, 3], local and/or systemic administration of methotrexate [4], bilateral hypogastric artery ligation associated with trophoblastic evacuation, and selective uterine artery embolization combined with curettage and/or MTX administration [5, 6]
We describe a case of viable cesarean scar pregnancy that was treated successfully by systemically administered MTX followed by a dilatation and curettage under ultrasound guidance
Summary
Cesarean scar pregnancy (CSP) is an ectopic pregnancy implanted in the myometrium at the site of a previous cesarean section scar. It is the rarest kind of ectopic pregnancy and may lead to severe complications, such as uterine disruption and severe hemorrhage [1]. Several types of conservative treatment have been used: dilatation and curettage, excision of trophoblastic tissues (laparotomy or laparoscopy) [2, 3], local and/or systemic administration of methotrexate [4], bilateral hypogastric artery ligation associated with trophoblastic evacuation, and selective uterine artery embolization combined with curettage and/or MTX administration [5, 6]. We describe a case of viable cesarean scar pregnancy that was treated successfully by systemically administered MTX followed by a dilatation and curettage under ultrasound guidance
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