scholarly journals Cesarean scar ectopic pregnancy: clinical case

2021 ◽  
Vol 38 (5) ◽  
pp. 153-160
Author(s):  
L. I. Korotovskikh ◽  
M. V. Koval ◽  
A. M. Bogdanova ◽  
L. D. Litvina ◽  
V. V. Tsypushkina
Keyword(s):  
Mortality Rate ◽  
Ectopic Pregnancy ◽  
Clinical Observation ◽  
Uterine Wall ◽  
Cesarean Scar Pregnancy ◽  
Rare Type ◽  
Cesarean Scar ◽  
Risk Of Death ◽  
Pathological Pregnancy

Today, cesarean scar pregnancy is a rare type of ectopic pregnancy (1:18001: 2200). Moreover, the mortality rate in cesarean scar pregnancy is 191.2 per 100 000 cases, that 12 times exceeds the mortality rate in tubal pregnancy. In this article, we present a clinical observation of a rare case of cesarean scar pregnancy, as diagnosed by ultrasonography, in a 23-year-old patient after the cesarean surgery. The diagnosis was based on clinical, biochemical and ultrasound studies. Ultrasound played a crucial role in the determination of the fetus localization. Pathological pregnancy was eliminated by means of excision of the old scar and restoration of the uterine wall integrity. Such cases are becoming more common in connection with the increase in the frequency of caesarean sections, the improvement of technology, continuing medical education and professional development in the field of ultrasound. Knowledge of differential diagnosis can save the patient's life since the outcomes of cesarean scar pregnancy include severe complications with a possible loss of patients fertile function and immediate risk of death.

scholarly journals Cesarean Scar Ectopic Pregnancy: Case Report and Review of the Literature

2016 ◽  
Vol 8 (1) ◽  
pp. 66-68
Author(s):  
Thankam Varma ◽  
Shashidhar Boraiah
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
Review Of The Literature ◽  
Artery Embolization ◽  
Cesarean Scar Pregnancy ◽  
Rare Type ◽  
Cesarean Scar ◽  
Maternal Morbidity And Mortality ◽  
Tertiary Care Hospitals

ABSTRACT Cesarean scar ectopic pregnancy is becoming increasingly common in tertiary care hospitals. Cesarean scar pregnancy is a rare type of ectopic pregnancy associated with complications, such as uterine rupture, uncontrollable bleeding which may lead to hysterectomy and increased maternal morbidity and mortality and subsequent infertility. Options available for treatment, such as dilatation and curettage, excision of trophoblastic tissues using laparotomy or laparoscopy, systemically administered methotrexate, and more recently uterine artery embolization. We report two such cases between 2012 and 2013 managed conservatively. How to cite this article Boraiah S, Varma T, Shankar K. Cesarean Scar Ectopic Pregnancy: Case Report and Review of the Literature. J South Asian Feder Obst Gynae 2016;8(1):66-68.

scholarly journals Cornual pregnancy-an unusual site of pregnancy: a case report and literature review

2019 ◽  
Vol 10 (1) ◽  
pp. 64-67
Author(s):  
Tanzeem S Chowdhury ◽  
Homaira Hasan ◽  
TA Chowdhury
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Cavity ◽  
Uterine Wall ◽  
Unusual Presentation ◽  
Cornual Pregnancy ◽  
Diagnostic Challenge ◽  
Unusual Site ◽  
Rare Type ◽  
Interstitial Pregnancy ◽  
Gestational Sac

Ectopic pregnancy is a condition where gestational sac is located outside the uterine cavity. Cornual pregnancy, also known as interstitial pregnancy, is a rare type of ectopic pregnancy that develops in the interstitial portion of the fallopian tube and invades through the uterine wall. It poses great diagnostic challenge because of its unusual presentation and late diagnosis. Cornual pregnancy, if not diagnosed early, may present with massive and uncontrollable bleeding even leading to maternal death. We hereby report an unusual presentation of cornual pregnancy which was diagnosed and subsequently managed successfully. Birdem Med J 2020; 10(1): 64-67

scholarly journals Conservative Management of Cesarean Scar Ectopic Pregnancy with Fetal Heart Activity and a Very Highβ-hCG

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Rodney McLaren ◽  
Sandra McCalla ◽  
Mohamad Irani
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Fetal Heart ◽  
Heart Activity ◽  
Artery Embolization ◽  
Rare Type ◽  
Prenatal Visit ◽  
Cesarean Scar ◽  
Very High

Cesarean scar ectopic pregnancy (CSP) is a rare type of ectopic pregnancy that is growing in incidence. The diagnosis of most CSP occurs when patients present in unstable conditions requiring surgical management and leading sometimes to hysterectomy. It has been shown that medical management is a safe option for early diagnosed hemodynamically stable CSP. However, no cases of CSP withβ-hCG higher than 62,000 IU/L, conservatively treated, have been reported. We report the case of a 29-year-old patient who presented for her first prenatal visit at 13-week gestation and was diagnosed with CSP with present fetal heart tones and a quantitativeβ-hCG of 144,337 IU/L. She was treated with bilateral uterine artery embolization and systemic methotrexate. Herβ-hCG significantly decreased and became undetectable within 10 weeks. We propose that patients with CSP with very highβ-hCG and fetal heart activity can be offered conservative or fertility preserving management.

scholarly journals Differential Diagnosis of Cesarean Scar Pregnancies and Other Pregnancies Implanted in the Lower Uterus by Ultrasound Parameters

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Kangning Li ◽  
Qing Dai
Keyword(s):  
Differential Diagnosis ◽  
Cesarean Section ◽  
Transvaginal Ultrasound ◽  
Previous Cesarean Section ◽  
Cesarean Scar Pregnancy ◽  
Rare Type ◽  
Cesarean Section Delivery ◽  
Cesarean Scar ◽  
The Relationship ◽  
Previous Cesarean

Purpose. Cesarean scar pregnancy is an extremely rare type of ectopic pregnancy implanted in the myometrium at the site of a previous cesarean section scar. On the other hand, pregnancies are considered low implantations if they are identified in the lower third of the uterus without the sac implanted into the scar and have a better prognosis. Early diagnosis of both types of pregnancies can help avoid serious complications. This study is aimed at investigating the significance of transvaginal ultrasound in the differential diagnosis of cesarean scar pregnancies and pregnancies implanted in the lower uterus. Methods. Ninety-three patients with an average age of 32.7 years (range, 24–43 years) were enrolled in this study, including 66 cesarean scar pregnancies and 27 other pregnancies implanted in the lower uterus, and they were examined by transvaginal ultrasound. Results. We observed significant differences in the relationship between the cesarean sac and the scar, the source of the trophoblastic blood flow, and the thickness of the residual muscle between the cesarean scar pregnancy group and the lower uterus pregnancy group. We established the logistic model to improve the differential diagnosis of cesarean scar pregnancies and pregnancies implanted in the lower uterus. Conclusions. Transvaginal ultrasound is recommended in early pregnancy, especially for patients who have undergone a previous cesarean section delivery.

scholarly journals Cesarean Scar Ectopic Pregnancy: The Lurking Danger in Post Cesarean Failed Medical Abortion

2020 ◽  
Author(s):  
Monika Anant ◽  
Anita Paswan ◽  
Chandrajyoti Chandrajyoti
Keyword(s):  
Cesarean Section ◽  
Ectopic Pregnancy ◽  
Medical Abortion ◽  
Accurate Diagnosis ◽  
Tertiary Level ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Life Threatening ◽  
Missed Diagnosis ◽  
Level Hospital

Cesarean scar pregnancy (CSP) is a potentially life threatening ectopic pregnancy where a missed diagnosis is commoner than an accurate diagnosis. Incidence of Ectopic pregnancy is 1 – 2 % and cesarean scar ectopic occurs in about (0.05%) 1 in 2000 of all pregnancies. With increasing cesarean section rates worldwide, CSP is bound to increase with its dreaded complications like uterine rupture and catastrophic hemorrhage. Three patients misdiagnosed as incomplete miscarriages in post cesarean pregnancies in other centers were found to be CSP in Gynaecology department of a tertiary level hospital. All three patients were managed successfully, two surgically and one medically.  

scholarly journals Identifying Risk Factors and Incidence Rates for Recurrent Cesarean Scar Pregnancy: A Nested Case-Control Study

2021 ◽  
Author(s):  
Sili He ◽  
Fei Zeng ◽  
Zhiwen Fan ◽  
Qi Tian ◽  
Jianfa Jiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Incidence Rates ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Induced Abortions ◽  
History Of ◽  
Group 2 ◽  
Nested Case Control

Abstract Background: Cesarean scar pregnancy (CSP) is a rare and dangerous ectopic pregnancy. CSP is a late severe complication of cesarean section. In recent years, with the introduction of the comprehensive second birth policy in China, the incidence of CSP and recurrent CSP has increased. However, there are no clear data available regarding the risk factors related to recurrent CSP in the literature. To identify risk factors and incidence rates for recurrent CSP. Methods: A total of 1000 CSP patients were followed up for 66 ± 19.5 months. Among them, 86 developed recurrent CSP during the follow-up period (group 1), and the remaining without recurrence were group 2. The clinical data of these cases were reviewed in this retrospective study. Results: The incidence rate of recurrent CSP is 8.6%, and the risk factors were a history of ectopic pregnancy and prior abortions. The incidence of RCSP in patients >-35-years-old was significantly lower than that in patients <35-years-old (P=0.031).Conclusions: Previous ectopic pregnancy is an independent risk factor for RCSP. Additionally, the higher the number of induced abortions, the higher the incidence of RCSP.

scholarly journals The Trend of the Distribution of Ectopic Pregnancy Sites and the Clinical Characteristics of Cesarean Scar Pregnancy

2021 ◽  
Author(s):  
Panpan Tang ◽  
Xiaomao Li ◽  
Wenwei Li ◽  
Yunhui Li ◽  
Yu Zhang ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Cesarean Delivery ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Cesarean Scar Pregnancy ◽  
Variation Trend ◽  
Cesarean Scar ◽  
Increasing Trend ◽  
Common Sign ◽  
Cesarean Delivery Rate

Abstract Objective: To investigate the distribution and its variation trend of the ectopic site and the clinical characteristics of cesarean scar pregnancy, to provide clues for further clinical practice. Methods: 3915 patients are brought into our study. To calculate the distribution of the implantation of ectopic pregnancy. Then analyze with trend χ2 test and calculate the quantity of each type of ectopic pregnancy during the year 2012-2015 and the year 2016-2019 to analyze the variation trend. Results: 1. The proportion of each site of ectopic pregnancy is as following: tubal pregnancy (84.70%), ovarian pregnancy (1.56%), cesarean scar pregnancy (8.63%), abdominal pregnancy (0.61%), cornual pregnancy (2.68%), cervical pregnancy (0.49%), heterotopic pregnancy (0.43%). 2. Through trend χ2 test, the ratio of cesarean scar pregnancy to ectopic pregnancy showed an increasing trend(P=0.005). From the year 2012-2015 to the year 2016-2019, the ratio of cesarean scar pregnancy to ectopic pregnancy increased from 5.74% to 11.81%(P<0.001). 3.72.78%(246/338) cesarean scar pregnancy patients had cesarean delivery once, 25.15%(85/338) had cesarean delivery twice, and 2.07%(7/338) had cesarean delivery three times. 80.18%(271/338) had aborted before. The most common clinical manifestations are amenorrhea (98.52%), abdominal pain (25.74%) and vaginal bleeding (67.76%), the most common sign is hysterauxesis (46.75%). Conclusion: As the increasing of the ratio of cesarean scar pregnancy to ectopic pregnancy, the cesarean delivery rate should be decreased to decrease the morbidity of cesarean scar pregnancy.

scholarly journals Cesarean scar pregnancy: clinicians challenge

2017 ◽  
Vol 6 (5) ◽  
pp. 2101
Author(s):  
Priyanka Harshavardhan Vora ◽  
Vandana Bansal
Keyword(s):  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Uterine Cavity ◽  
Cesarean Scar Pregnancy ◽  
Sequential Approach ◽  
Cesarean Scar ◽  
Caesarean Scar

A case of caesarean scar ectopic pregnancy managed diagnosed early on transvaginal ultrasound and managed successfully by sequential approach of methotrexate and hysteroscopic removal preserving the woman’s fertility is discussed below. Ectopic pregnancy i.e. implantation of the blastocyst outside the endometrium of the uterine cavity occurs in 1.9% of reported pregnancies.

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