Skip to main content
SpringerLink
Log in

Caesarean scar pregnancy: hysterotomy is rapid and safe management option

  • Case Report
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Caesarean scar pregnancy (CSP) is implantation of the gestational sac within the hysterotomy scar. Ultrasound is the main diagnostic tool. Early diagnosis and termination of pregnancy is crucial to avoid the risk of uterine rupture. The termination modalities available are dilatation and curettage, methotrexate therapy, hysteroscopy, uterine artery embolization and laparotomy. We present a case of undisturbed CSP which presented at 6 weeks + 6 days gestation. Our management was termination of pregnancy by exploratory laparotomy and hysterotomy for excision of the mass. The postoperative period was uneventful and there was rapid decline of beta human chorionic gonadotrophin to the normal level.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Seow KM, Huang LW, Lin YH, Lin MY, Tsai YL, Hwang JL (2004) Cesarean scar pregnancy: issues in management. Ultrasound Obstet Gynecol 23:247–253

    Article  PubMed  Google Scholar 

  2. Timor-Tritsch IE, Monteagudo A (2012) Unforeseen consequences of the increasing rate of cesarean deliveries: early placenta accreta and cesarean section scar pregnancy; a review. Am J Obstet Gynecol 207(1):14–29

    Article  PubMed  Google Scholar 

  3. Ash A, Smith A, Maxwell D (2007) Caesarean scar pregnancy. Br J Obstet Gynaecol 3(114):253–263

    Article  Google Scholar 

  4. Einenkel J, Stumpp P, Kosling S, Horn LC, Hockel M (2005) A misdiagnosed case of caesarean scar pregnancy. Arch Gynecol Obstet 271:178–181

    Article  PubMed  Google Scholar 

  5. Fylstra DL (2002) Ectopic pregnancy within a cesarean scar: a review. Obstet Gynecol Surv 57:537–543

    Article  PubMed  Google Scholar 

  6. Godin PA, Bassil S, Donnez J (1997) An ectopic pregnancy developing in a previous cesarean section scar. Fertil Steril 67:398–400

    Article  CAS  PubMed  Google Scholar 

  7. Shih JC (2004) Cesarean scar pregnancy: diagnosis with three-dimensional (3D) ultrasound and 3D power Doppler. Ultrasound Obstet Gynecol 23(3):306–307

    Article  PubMed  Google Scholar 

  8. Wang CJ, Yuen LT, Yen CF, Lee CL, Soong YK (2004) Three-dimensional power Doppler ultrasound diagnosis and laparoscopic management of a pregnancy in a previous cesarean scar. J Laparoendosc Adv Surg Tech A 14(6):399–402

    Article  PubMed  Google Scholar 

  9. Rotas MA, Haberman S, Levgur M (2006) Cesarean scar ectopic pregnancies: etiology, diagnosis, and management. Obstet Gynecol 107:1373–1381

    Article  PubMed  Google Scholar 

  10. Timor-Tritch IE, Montequdo A, SantosSantos R, Tsymbal T, Pineda G, Arslan AA (2012) The diagnosis, treatment, and follow-up of cesarean scar pregnancy. Am J Obstet Gynecol 1(207):1–13

    Google Scholar 

  11. Maymon R, Halperin R, Mendlovic S, Schneider D, Herman A (2004) Ectopic pregnancies in a caesarean scar: review of the medical approach to an iatrogenic complication. Hum Reprod Update 10:515–523

    Article  CAS  PubMed  Google Scholar 

  12. Donnez J, Godin PA, Bassil S (1997) Successful methotrexate treatment of a viable pregnancy within a thin uterine scar. Br J Obstet Gynaecol 104:1216–1217

    Article  CAS  PubMed  Google Scholar 

  13. Wang CJ, Chao AS, Yuen LT, Wang CW, Soong YK, Lee CL (2006) Endoscopic management of cesarean scar pregnancy. Fertil Steril 85:494–497

    PubMed  Google Scholar 

  14. Vial Y, Petignat P, Hohlfeld P (2000) Pregnancy in a cesarean scar. Ultrasound Obstet Gynecol 16:592–593

    Article  CAS  PubMed  Google Scholar 

  15. Larsen JV, Solomon MH (1978) Pregnancy in a uterine scar sacculus–an unusual cause of postabortal haemorrhage. a case report. S Afr Med J 53:142–143

    CAS  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Cairo University, 28 al arkam ibn abi al arkam street, Al meraj, al maadi, Cairo, Egypt

    Mohamed Ali Abdelkader, Reham Fouad, Amr Hosny Gebril & Mohamed Ahmed El Far

  2. Department of Pathology, Cairo University, 28 al arkam ibn abi al arkam street, Al meraj, al maadi, Cairo, Egypt

    Dina Fauzi Elyassergi

Authors
  1. Mohamed Ali Abdelkader
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Reham Fouad
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Amr Hosny Gebril
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mohamed Ahmed El Far
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dina Fauzi Elyassergi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Reham Fouad.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Abdelkader, M.A., Fouad, R., Gebril, A.H. et al. Caesarean scar pregnancy: hysterotomy is rapid and safe management option. Arch Gynecol Obstet 290, 381–383 (2014). https://doi.org/10.1007/s00404-014-3206-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-014-3206-8

Keywords

Search

Navigation