Document Detail


Expectant treatment of cesarean scar pregnancy: two case reports and a glimpse at the natural courses.
MedLine Citation:
PMID:  20180129     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Pregnancy in previous cesarean scar is the rarest form of ectopic pregnancy. Little is known about its natural history and optimal management. All except one reported case in the literature that were treated expectantly either become unsuccessful or complicated. We aimed to present two cases of cesarean scar pregnancy (CSP) that were managed expectantly to discuss the value of this management and have a glimpse of the natural courses of certain CSPs.
CASES: We present two cases of parous women with complaint of amenorrhea and mild bleeding. Sonography and magnetic resonance imaging (MRI) revealed the diagnosis of CSP without viable gestational sac. The patients opted for expectant treatment. We closely monitored the patients with a detailed plan.
RESULTS: In case 1, the patient had mild bleeding during monitoring and her serum betaHCG dropped quickly to normal range after 7 weeks. She was fully recovered with total absorption of the mixed mass in the scar of the anterior wall of the uterus. In case 2, the patient had laparoscopy after expectant management for 16 weeks because her serum betaHCG reached a plateau between 30 and 40 mIU/mL for 4 weeks and there was no obvious resorption of the mixed mass within the lower anterior wall of the uterus. The histopathology revealed decidualized villa within organizing tissue and the patient recovered uneventfully.
CONCLUSIONS: CSP with no viable gestation sac and rapidly decreased serum betaHCG level can be expectantly treated. The natural history of such CSPs may be naturally demised.
Authors:
Haiyuan Liu; Jinhua Leng; Honghui Shi; Jinghe Lang
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Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2010-02-24
Journal Detail:
Title:  Archives of gynecology and obstetrics     Volume:  282     ISSN:  1432-0711     ISO Abbreviation:  Arch. Gynecol. Obstet.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-07     Completed Date:  2011-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710213     Medline TA:  Arch Gynecol Obstet     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  455-8     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China. haiyuanliu@163.com
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MeSH Terms
Descriptor/Qualifier:
Abortion, Induced / methods
Adult
Cesarean Section*
Chorionic Gonadotropin, beta Subunit, Human / blood
Cicatrix / complications*
Female
Humans
Laparoscopy
Magnetic Resonance Imaging
Pregnancy
Pregnancy, Ectopic / diagnosis*,  therapy*
Treatment Outcome
Ultrasonography, Prenatal
Watchful Waiting
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin, beta Subunit, Human

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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