Document Detail

Cesarean scar ectopic pregnancy in a patient with multiple prior cesarean sections: a case report.
MedLine Citation:
PMID:  19438168     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cesarean scar pregnancy, an abnormal gestation implanted in the hysterotomy site of a previous cesarean section, is a unique type of ectopic pregnancy. Once uncommon, these life-threatening gestations are increasing in frequency. Outcomes depend on a high index of suspicion and early diagnosis. CASE: A 39-year-old, gravida 9, para 5-0-3-5, with a history of 5 cesarean deliveries, presented with vaginal bleeding secondary to cesarean scar pregnancy at 8 weeks' gestation. The patient, who desired future fertillty, was successfully treated conservatively with methotrexate and uterine artery embolization. CONCLUSION: Reports of cesarean scar pregnancies are rising in the literature, and we describe a scar pregnancy in a woman with multiple prior cesareans. Although the relationship between cesarean scar pregnancy and the number of previous cesarean deliveries is unclear, rising cesarean section rates worldwide will further increase overall incidence. The optimal treatment modality remains uncertain, but conservative management is appropriate when desired by the patient and administered under close observation.
Jessica Kiley; Lee P Shulman
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  54     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-05-14     Completed Date:  2009-06-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  251-4     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USA.
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MeSH Terms
Abortifacient Agents, Nonsteroidal / therapeutic use
Cesarean Section* / adverse effects
Chorionic Gonadotropin, beta Subunit, Human / blood
Cicatrix* / etiology
Embolization, Therapeutic
Magnetic Resonance Imaging
Methotrexate / therapeutic use
Pregnancy, Ectopic / diagnosis*,  therapy,  ultrasonography
Uterine Hemorrhage
Uterus / blood supply
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 0/Chorionic Gonadotropin, beta Subunit, Human; 59-05-2/Methotrexate

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