Laparoscopic treatment of cesarean scar ectopic pregnancy

Authors

HUDEČEK Robert FELSINGEROVÁ Zuzana FELSINGER Michal JANDÁKOVÁ Eva

Year of publication 2014
Type Article in Periodical
Magazine / Source Journal of gynecologic surgery
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1089/gyn.2014.0005
Field Gynaecology and obstetrics
Keywords laparoscopy; cesarean scar ectopic pregnancy
Description An ectopic pregnancy within a Cesarean scar represents a rare type of extrauterine pregnancy in which the fertilized egg nidates in the myometrium of the uterine wall within a scar left from a previous Cesarean delivery. An unrecognized growing Cesarian scar pregnancy may result in uterine rupture, uncontrollable me- trorrhagia, and bleeding into the abdominal cavity; therefore, early diagnosis and therapy are necessary to prevent the development of severe complications. Case: A 34-year-old woman after a previous Cesarean delivery presented with amenorrhoa of 7 weeks’ duration. Transvaginal ultrasonography revealed an ectopic pregnancy in the Cesarean scar, and a laparoscopic removal of the gestational sac was performed with no complications. Results: Three months later, another laparoscopy with chromopertubation showed no signs of penetration in the suture, both the Fallopian tubes being bilaterally passable. The patient was advised that she could try to achieve pregnancy through spontaneous conception, after which monitoring of the gestational development and a careful assessment of the nidation site would be needed. Conclusions: Laparoscopic surgical management of a viable ectopic pregnancy is technically simple, and is followed by a good recovery.

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