Laparoscopic management of a 13 weeks viable ectopic cesarean section Scar pregnancy: a case report (original) (raw)
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Fertility and Sterility, 2009
Objective: To present a case of laparoscopic removal of a heterotopic cesarean scar pregnancy under ultrasound guidance. Design: Case report. Setting: Private hospital. Patient(s): A 34-year-old woman with heterotopic cesarean scar pregnancy. Intervention(s): Laparoscopic removal of heterotopic cesarean scar pregnancy. Main Outcome Measure(s): Delivery at term after laparoscopic management of heterotopic cesarean scar pregnancy. Result(s): An ongoing intrauterine pregnancy ended with a live birth after successful removal of the heterotopic gestational mass by a laparoscopic approach. Conclusion(s): Surgical removal of the ectopic mass by laparoscopy may be a radical approach in cases of heterotopic cesarean scar pregnancy. Laparoscopic excision of the cesarean scar pregnancy gives the opportunity to preserve the viable intrauterine gestation while maintaining a strong lower uterine segment. Ultrasound is an adjunctive tool that enables precise location of the ectopic mass during the operation. (Fertil Steril Ò 2009;91: 1293.e5-e7.
Conventional laparotomy for management of caesarean scar ectopic pregnancy: a case report
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2015
Increase in the rates of caesarean deliveries has led to a concurrent rise in the number of caesarean scar ectopic pregnancies (CSEP). With recent advances, diagnosis can be made at an early gestational age, hence facilitating a prompt intervention. With the varied treatment options available, choosing the right one may possess a clinical dilemma. However, in a low resource setting, conventional laparotomy may be the only option feasible. A case of CSEP managed with laparotomy is presented.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Caesarean scar ectopic pregnancy is a rare but potentially life threatening entity. The diagnosis and treatment of caesarean scar pregnancy is challenging. The true incidence has not been determined as there are only few cases reported in the literature. The optimal management of this condition is individualized based on various factors. Here we report a case of caesarean scar pregnancy with scar dehiscence which was successfully managed laparoscopically. Patient underwent laparoscopy with complete removal of trophoblastic tissue, repair of scar defect following prophylactic bilateral ligation of anterior division of internal iliac artery without need for blood transfusion. Laparoscopy is an effective and minimally invasive approach in dealing with scar pregnancy.
Cesarean Scar Ectopic Pregnancy: A Diagnostic and Management Challenge
Cureus, 2021
Cesarean section scar pregnancy is the rarest form of ectopic pregnancy. Cesarean scar ectopic pregnancy poses a diagnostic and management challenge, and if not diagnosed and adequately treated in early pregnancy, it may lead to considerable maternal morbidity or mortality. We describe the presentation, workup including radiology studies, and subsequent management plan of a cesarean scar ectopic pregnancy in a 34-year-old female with a history of four previous cesarean sections. We were successful in treating this rare form of ectopic pregnancy without any maternal morbidity with a combination of medical and surgical management.
Conservative management of a Cesarean scar ectopic pregnancy: a case report
Cases Journal, 2009
Introduction: Cesarean scar pregnancy is the rarest kind of ectopic pregnancy. The immediate prognosis depends on the risks associated with uterine rupture and massive bleeding. Case presentation: A 32-year-old woman (gravida 2, para 1) presented with massive vaginal bleeding. A Cesarean scar pregnancy was diagnosed. She was treated by local methotrexate injection, followed by uterine artery embolization. Recurrence of bleeding necessitated two repeat embolizations. Hysteroscopy four months later revealed the presence of a uterine defect within the Cesarean section scar. Conclusion: Cesarean scar pregnancy should be diagnosed and treated as soon as possible to prevent severe complications and spare fertility.
Cesarean section scar ectopic pregnancy - a management conundrum: a case report
Journal of Medical Case Reports, 2019
Background: Cesarean section scar ectopic pregnancies are a rare complication of pregnancy that may follow previous hysterotomy for any cause, uterine manipulation, and in vitro fertilization. It has become more common with the increasing number of cesarean sections worldwide. Fortunately, the use of first-trimester ultrasound imaging has led to a significant number of these pregnancies being diagnosed and managed early. Case presentation: We report a case of a 36-year-old black African patient who had two previous cesarean sections and one previous surgical evacuation. She presented with a type 2 cesarean section scar ectopic pregnancy that was suspected on the basis of transvaginal ultrasound imaging, but not at laparoscopy/hysteroscopy. A bladder adherent to the upper segment of the anterior uterine wall obscured the gestational mass at laparoscopy. There were extensive intracavitary adhesions that interfered with hysteroscopic visualization. This resulted in the original operative procedure being postponed until magnetic resonance imaging confirmed the ectopic location of the pregnancy. The ectopic gestation was subsequently excised, and the uterus was repaired via laparotomy. Conclusions: It is important for clinicians and radiologists managing women with risk factors for a scar ectopic pregnancy to maintain a high index of suspicion during follow-up. Failure to diagnose and initiate prompt management may lead to uterine rupture, massive hemorrhage, and maternal death.