Diagnostic and management challenges of a rare case of caesarean scar pregnancy in a low-resource setting: a case report.

Autor:	Nwankwo ME; Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.; Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Awka, Anambra State, Nigeria., Egeonu RO; Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Ikeotuonye AC; Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Eleje GU; Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.; Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Awka, Anambra State, Nigeria., Okafor CO; Department of Radiology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria., Ikpeze GC; Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Ugadu SN; Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Agbanu CM; Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Nwankwo AF; Department of Microbiology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria., Okafor CG; Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
Jazyk:	angličtina
Zdroj:	SAGE open medical case reports [SAGE Open Med Case Rep] 2024 Sep 25; Vol. 12, pp. 2050313X241286670. Date of Electronic Publication: 2024 Sep 25 (Print Publication: 2024).
DOI:	10.1177/2050313X241286670
Abstrakt:	Caesarean scar pregnancy is a rare type of ectopic pregnancy with the potential for catastrophic outcomes. A high index of suspicion is required for prompt diagnosis and intervention to improve outcomes. This report describes a rare case of Caesarean scar pregnancy, which was initially misdiagnosed as a threatened miscarriage and cervical ectopic pregnancy. A 35-year-old multiparous lady with two previous caesarean sections presented to the Gynaecology Unit of the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nigeria, at an estimated gestational age of 10 weeks, with recurrent vaginal bleeding of eight weeks' duration. She was referred to our facility from a private hospital, where she had first been managed as a case of threatened miscarriage and later as a cervical ectopic pregnancy. The transvaginal ultrasound in our facility was in keeping with a viable Caesarean scar pregnancy. The urine pregnancy test was positive, and the quantitative serum beta human chorionic gonadotropin was 75.6 mIU/ml. She had initial medical treatment with a combination of systemic multidose and intrauterine sac methotrexate and, subsequently, hysterotomy. Following systemic and local methotrexate, there was the demise of the foetus, which was evacuated at hysterotomy, and the uterine scar defect was repaired. She was discharged home in stable clinical condition one week after surgery. Her serum beta human chorionic gonadotropin dropped to 51.6 mIU/mL two weeks post-hysterotomy, and her urine pregnancy test became negative three weeks later. Though rare, caesarean scar pregnancy should be considered a differential diagnosis in reproductive-aged women with a previous caesarean section who present with vaginal bleeding in the first trimester. Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© The Author(s) 2024.)
Databáze:	MEDLINE
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