Cesarean Scar – Unusual Site of Ectopic Pregnancy: A Case Report
| Autor: | Afnan Mohamed, Mohammed Al Gadeeb, Jumana Al Matrouk, Zainab Faisal, Sumaya Al Gadeeb |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Gestational sac 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Laparotomy medicine Pregnancy cesarean scar Ectopic pregnancy business.industry Fetal pole General Engineering medicine.disease Surgery medicine.anatomical_structure Obstetrics/Gynecology ectopic pregnancy Methotrexate Uterine cavity business Radiology 030217 neurology & neurosurgery Fallopian tube medicine.drug |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| Popis: | Ectopic pregnancy is a leading cause of maternal mortality in the first trimester. It may occur in different anatomic locations with fallopian tube being the most frequent. Cesarean-scar ectopic pregnancy is one of the rarest ectopic pregnancies. We report the case of a 44-year-old woman, gravida 5 para 4, who attended the antenatal clinic after her pregnancy was confirmed by positive urine testing. She underwent transvaginal ultrasound examination which identified the gestational sac with fetal pole and cardiac activity located in the anterior part of the lower uterine segment with empty uterine cavity. Magnetic resonance imaging (MRI) scan had confirmed the diagnosis of cesarean scar ectopic pregnancy. After through discussion on the management options, the patient was treated with intra-gestational sac injection of methotrexate. Four days after the procedure, she developed profuse vaginal bleeding and her hemoglobin showed a drop of 4.9 g/dL. She underwent emergency laparotomy with excision of the ectopic pregnancy. The patient tolerated the procedure well without complications. The serum β-human chorionic gonadotropin level was undetectable on the 35th day after the methotrexate injection. Caesarean scar pregnancy is an unusual form of ectopic pregnancy. However, clinicians should have a high index of suspicion for this condition as it may result in serious complications, unless promptly managed. MRI is recommended particularly when transvaginal ultrasound scan is inconclusive. |
| Databáze: | OpenAIRE |
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