Erin E Stevens1, Paul Ogburn. 1. Department of Obstetrics and Gynecology, Stony Brook University Medical Center, Stony Brook, NY 11733, USA. erin.e.stevens@gmail.com
Abstract
BACKGROUND: Cesarean scar ectopic pregnancies have been diagnosed with increasing frequency in the last decade. There is no consensus of management for these pregnancies; however, prior reports have suggested best results using either combination methotrexate therapy or surgical excision. CASE: We present a case of failed systemic and local methotrexate therapy requiring operative management, CONCLUSION: Cesarean scar ectopic pregnancies can have disastrous outcomes, including uterine rupture, massive hemorrhage and maternal death. Although this is the first case to report a failure of the combination therapy, major morbidities did not occur. We believe this is due to our choice of expedient surgical management.
BACKGROUND: Cesarean scar ectopic pregnancies have been diagnosed with increasing frequency in the last decade. There is no consensus of management for these pregnancies; however, prior reports have suggested best results using either combination methotrexate therapy or surgical excision. CASE: We present a case of failed systemic and local methotrexate therapy requiring operative management, CONCLUSION: Cesarean scar ectopic pregnancies can have disastrous outcomes, including uterine rupture, massive hemorrhage and maternal death. Although this is the first case to report a failure of the combination therapy, major morbidities did not occur. We believe this is due to our choice of expedient surgical management.