Ectopic pregnancy in previous cesarean scar
https://doi.org/10.52485/19986173_2023_1_173
Abstract
Сesarean scar pregnancy is a rare type of ectopic pregnancy which associated with high risk of maternal complication. The review included modern data on prevalence, etiology, pathogenesis and treatment of cesarean scar pregnancy. The paper describes a clinical case of cesarean scar pregnancy with a favorable outcome for the reproductive function of patient. The diagnostic difficulties and surgical tactics of the patient's management are described. An individual approach is needed to assess early uterine pregnancy in patients with a history of cesarean section. Timely diagnosis of pregnancy in the scar is the key to successful organ-preserving surgery.
Supporting agencies: The study was not funded by anyone
About the Authors
S. A. Iozefson
Chita State Medical Academy
Russian Federation
Russian Federation
672000; 39a Gorky Street; Chita
T. E. Belokrinitskaya
Chita State Medical Academy
Russian Federation
Russian Federation
672000; 39a Gorky Street; Chita
E. V. Golygin
Region Clinical Hospital
Russian Federation
Russian Federation
672038; 7 Kokhanskogo str.; Chita
I. B. Plotkin
Region Clinical Hospital
Russian Federation
Russian Federation
672038; 7 Kokhanskogo str.; Chita
S. I. Kuklin
Region Clinical Hospital
Russian Federation
Russian Federation
672038; 7 Kokhanskogo str.; Chita
D. S. Kargina
Region Clinical Hospital
Russian Federation
Russian Federation
672038; 7 Kokhanskogo str.; Chita
E. V. Shal'nyova
Region Clinical Hospital
Russian Federation
Russian Federation
672038; 7 Kokhanskogo str.; Chita
A. I. Galeeva
Chita State Medical Academy
Russian Federation
Russian Federation
672000; 39a Gorky Street; Chita
References
1. Shmakov R.G., Martirosian S.V., Mikhailov A.V., Pyregov A.V., Fatkullin I.F., Shifman E.M., Adamian L.V., Artymuk N.V., Baev O.R., Baranov I.I., Bashmakova N.V., Bezhenar V.F., Belokrinitskaya T.E., Vagushchenko U.A., Dolgushina N.V., Zabolotskikh I.B., Kinzhalova S.V., Klimov V.A. Single-child labor, delivery by caesarean section. Clinical recommendations approved by the ROAG and the Ministry of Health of the Russian Federation. ID:639. Moscow, 2021. 106 p. in Russian
2. Adamjan L.V., Artymuk N.V., Belokrinitskaya T.E., Kozachenko A.V., Procenko D.N., Pyregov A.V., Rogachevskij O.A., Smol'nova T.Ju., Suturina L.V., Filippov O.S., Shifman E.M., Kulikov A.V., Ovezov A.M., Shhukina N.A., Tonojan N.M. Ectopic (ectopic) pregnancy. Clinical recommendations approved by the ROAG and the Ministry of Health of the Russian Federation. ID:642. Moscow, 2021. 60 p. in Russian
3. Larsen J.V., Solomon M.H. Pregnancy in the uterine scar sacculus is an unusual case of postpartum bleeding. The report of the case. S Afr Med J. 1978; 53: 142-143.
4. Buyanova S.N., Shchukina N.A., Chechneva M.A., Puchkova N.V. Pregnancy in the scar after cesarean section: the possibility of surgical correction. 2020;20 (6): 65-70. in Russian
5. Ash A., Smith A., Maxwell D. Caesarean scar pregnancy. BJOG. 2007; 114(3): 253-63.
6. Ouyang Y., Li X., Yi Y., Gong F., Lin G., Lu G. First-trimester diagnosis and management of Cesareanscar pregnancies after in vitro fertilization-embryo transfer: a retrospective clinical analysis of 12 cases. Reprod. Biol. Endocrinol. 2015; 13: 126.
7. Maymon R., Halperin R., Mendlovic S., Schneider D., Vaknin Z., Herman A., Pansky M. Ectopic pregnancies in Caesarean section scars: the 8 year experience of one medical centre. Hum. Reprod. 2004; 19(2): 278-84.
8. Sidorov A.E., Sidorov E.S., Samoylova A.V., Gunin A.G. Pregnancy in the uterine scar after cesarean section. Zdravoohranenie Chuvashii. 2014; 3(39): 49-56. in Russian
9. Tsai S.W., Huang K.H., Ou Y.C., Hsu T.Y., Wang C.B., Chang M.S. Li K.H., Kung F.T. Low-lying-implantation ectopic pregnancy: a cluster of cesarean scar, cervico-isthmus, and cervical ectopic pregnancies in the first trimester. Taiwan. J. Obstet. Gynecol. 2013; 52(4): 505-11.
10. Weimin W., Wenqing L. Effect of early pregnancy on a previous lower segment cesarean section scar. Int. J.Gynaecol. Obstet. 2002;77(3): 201-7.
11. Sadeghi H., Rutherford T., Rackow B.W., Campbell K.H., Duzyj C.M., Guess M.K., Kodaman P.H., Norwitz E.R. Cesarean scar ectopic pregnancy : case series and review of the literature. Am J Perinatol. 2010 Feb;27(2):111-20.
12. Strizhakov A.N., Davydov A.I., Rubina E.V. Cesarean scar pregnancy. Voprosy ginekologii, akusherstva i perinatologii. 2016;15 (5): 67-72. in Russian
13. Qi F., Zhou W., Wang M.F., Chai Z.Y., Zheng L.Z. Uterine artery embolization with and without local methotrexate infusion for the treatment of cesarean scar pregnancy. Taiwan. J. Obstet. Gynecol. 2015; 54(4): 376-80.
14. Gao L., Huang Z., Zhang X., Zhou N., Huang X., Wang X. Reproductive outcomes following cesarean scar pregnancy – a case series and review of the literature. Eur. J. Obstet. Gynecol. Reprod. Biol. 2016; 200: 102-7.
15. Chiang A.J., La V., Chou C.P., Wang P.H., Yu K.J. Ectopic pregnancy in a cesarean section scar. Fertil. Steril. 2011; 95(7): 2388-9.
16. Rotas M.A., Haberman S., Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management. Obstet. Gynecol. 2006; 107(6): 1373-81.
17. Moschos E., Wells C.E., Twickler D.M. Biometric sonographic findings of abnormally adherent trophoblastic implantations on ceasarean delivery scars. J. Ultrasound Med. 2014; 33(3): 475-481.
18. Tskhay V.B., Yametov P.K., Vergunov N.A. Cesarean scar pregnancy. Current state of the problem. Diagnostics. Clinical symptoms. Medical tactics. Akusherstvo I ginecologiya. 2017; 3: 5-10. in Russian
19. Kanat-Pektas M., Bodur S., Dundar O., Bakır V.L. Systematic review: What is the best first-line approach for cesarean section ectopic pregnancy? Taiwan. J. Obstet. Gynecol. 2016; 55(2): 263-9.
20. Muraji M., Mabuchi S., Hisamoto K., Muranishi M., Kanagawa T., Nishio Y. et al. Cesarean scar pregnancies successfully treated with methotrexate. Acta Obstet. Gynecol. Scand. 2009;88(6): 720-3.
21. Bayoglu T.Y., Mete U.U., Balik G., Ustuner I., Kir S.F., Güvendağ G.E.S. Management of cesarean scar pregnancy with suction curettage: a report of four cases and review of the literature. Arch. Gynecol. Obstet. 2014;289(6): 1171-5.
22. Jurkovic D., Knez J., Appiah A., Farahani L., Mavrelos D., Ross J.A. Surgical treatment of Cesarean scar ectopic pregnancy: efficacy and safety of ultrasound-guided suction curettage. Ultrasound Obstet. Gynecol. 2016; 47(4): 511-7.
23. Wu X., Zhang X., Zhu J., Di W. Caesarean scar pregnancy: comparative efficacy and safety of treatment by uterine artery chemo embolization and systemic methotrexate injection. Eur. J. Obstet. Gynecol. Reprod. Biol. 2012;161(1): 75-9.
24. He Y., Wu X., Zhu Q., Wu X., Feng L., Wu X., Zhao A., Di W. Combined laparoscopy and hysteroscopy vs. uterine curettage in the uterine artery embolization-based management of cesarean scar pregnancy: a retrospective cohort study. BMC Womens Health. 2014 Sep 24; 14:116.
25. Api M., Boza A., Gorgen H., Api O. Should cesarean scar defect be treated laparoscopically? A case report and review of the literature. J. Minim. Invasive Gynecol. 2015; 22(7): 1145-52.
Review
For citations:
Iozefson S.A., Belokrinitskaya T.E., Golygin E.V., Plotkin I.B., Kuklin S.I., Kargina D.S., Shal'nyova E.V., Galeeva A.I. Ectopic pregnancy in previous cesarean scar. Transbaikalian Medical Bulletin. 2023;(1):173-181. (In Russ.) https://doi.org/10.52485/19986173_2023_1_173
Views:
119
Email this article 