P A Godin1, S Bassil, J Donnez. 1. Catholic University of Louvain, Department of Gynecology, St. Luc University Clinics, Brussels, Belgium.
Abstract
OBJECTIVE: To report the diagnosis and management of an ectopic pregnancy (EP) developing in a caesarean section scar. DESIGN: Case report. SETTING: University medical school. PATIENT(S): A patient with a previous history of two caesarean sections developing an EP. INTERVENTION(S): Methotrexate (MTX) was administered locally under ultrasonographic guidance. MAIN OUTCOME MEASURE(S): Weekly screening of blood hCG levels and yolk sac resorption by endovaginal sonography. RESULT(S): The diagnosis was suspected by vaginal echography and confirmed by magnetic resonance imaging. Local injection of KCl and MTX provoked a progressive resorption of the pregnancy. Human chorionic gonadotropin was undetectable on day 82. CONCLUSION(S): To prevent uterine rupture in cases of an EP developing in a caesarean section scar, a medical approach can be proposed.
OBJECTIVE: To report the diagnosis and management of an ectopic pregnancy (EP) developing in a caesarean section scar. DESIGN: Case report. SETTING: University medical school. PATIENT(S): A patient with a previous history of two caesarean sections developing an EP. INTERVENTION(S): Methotrexate (MTX) was administered locally under ultrasonographic guidance. MAIN OUTCOME MEASURE(S): Weekly screening of blood hCG levels and yolk sac resorption by endovaginal sonography. RESULT(S): The diagnosis was suspected by vaginal echography and confirmed by magnetic resonance imaging. Local injection of KCl and MTX provoked a progressive resorption of the pregnancy. Human chorionic gonadotropin was undetectable on day 82. CONCLUSION(S): To prevent uterine rupture in cases of an EP developing in a caesarean section scar, a medical approach can be proposed.
Authors: Catherine H Phillips; Jeremy R Wortman; Elizabeth S Ginsburg; Aaron D Sodickson; Peter M Doubilet; Bharti Khurana Journal: Emerg Radiol Date: 2017-09-25