Caesarean scar ectopic pregnancy: Discussion of 7 cases with literature reviews

Abstract

Objective: The aim of this study is to emphasize the importance of unsuspended treatment of the caesarean scar ectopic pregnancies diagnosed in early trimester and to remind once again that hysteroscopy can be the first option in such cases. It is intended to provide guidance in the selection of treatment method for the caesarean scar pregnancies terminated in early weeks. Material and Methods: Treatment options for seven patients who were admitted to "Istanbul Civilization University Obstetrics and Gynecology Department of Göztepe Training and Research Hospital" and diagnosed with caesarean scar pregnancies are discussed. Results: The duration of the pregnancies were 6 weeks, 8 weeks and 3 days. All of them were diagnosed by ultrasound examination. Due to diagnosis in early weeks, 5 patients' pregnancy materials were removed by hysteroscopy and being in late weeks of her pregnancy one patients' pregnancy materials were removed by laparotomy. Because of the hemorrhage ensuing the Dilatation/Curettage (D/C) procedure accompanied with ultrasound examination, one patients' scar tissue was removed by laparotomy. Then bilateral uterine and hypogastric artery ligation were performed on this patient due to severe hemorrhage. Conclusion: In caesarean scar pregnancies, terminating the pregnancy immediately by informing the patient will reduce the risk of maternal mortality and morbidity. As a result of diagnosis and treatment in the first trimester, none of the 7 patients mentioned here required hysterectomy.