Document Detail


Recurrent ectopic pregnancy in a cesarean scar.
MedLine Citation:
PMID:  18239016     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Ectopic pregnancy in a cesarean scar is a rare but well-recognized potential complication of cesarean delivery. Multiple risk factors exist, including prior uterine surgery, a history of uterine infections such as endomyometritis, and a brief interval between uterine surgery and subsequent conception. It is important to recognize such cases early, due to the risk for uterine rupture and catastrophic hemorrhage at early gestational ages. CASE: This patient presented for a dating ultrasound examination at 4 6/7 weeks of gestation. Her history was significant for an ectopic pregnancy in her cesarean scar 3 years prior that was managed by surgical resection. The initial ultrasound examination was suspicious for a recurrent ectopic pregnancy in her cesarean scar. The diagnosis was confirmed on repeat ultrasonography at 6 weeks of gestation. She was treated with methotrexate, and the pregnancy resolved without complication. CONCLUSION: Ectopic pregnancy in a cesarean scar is an important diagnosis to consider in a woman who has had a history of cesarean delivery and whose early ultrasonography shows a thin, lower uterine segment or a low implantation site. If the diagnosis is not clear on initial ultrasound examination, the patient should be followed up with serial ultrasound examinations. Once recognized, patients with this complication may be treated either surgically or medically as indicated by the clinical situation.
Authors:
Marium G Holland; Jessica L Bienstock
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  111     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-01     Completed Date:  2008-03-27     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  541-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Gynecology and Obstetrics, the Johns Hopkins University, Baltimore, MD 21230, USA. mghsmith@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Cesarean Section / adverse effects*
Cicatrix / etiology*
Female
Humans
Pregnancy
Pregnancy, Ectopic / diagnosis,  etiology*,  therapy

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


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