How to Treat Cesarean Scar Pregnancy: A Difficult and Rare Case

Ambrósio, B; Ferreira, AP; Correia, A

http://hdl.handle.net/10400.10/2267

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Authors

Ambrósio, B

Ferreira, AP

Correia, A

Abstract(s)

Background: Cesarean scar ectopic pregnancy is a rare type of ectopic pregnancy. Due to high morbidity and mortality associated with delayed diagnosis of this condition, a high index of suspicion is important, as well as a thorough transvaginal ultrasound. There is still no consensus on the best treatment of these cases. The choice for conservative options, including medical therapy with methotrexate and transvaginal evacuation, avoids mutilating surgeries, such as hysterectomy, which can compromise women's fertility. Case: A 32-year-old patient with a cesarean scar pregnancy with a 7 weeks live embryo. Results: The patient was treated with transvaginal evacuation and a single dose of intramuscular methotrexate, after an initial attempt with medical treatment, consisting of a local injection of potassium chloride into the sac, proved to be technically impossible. Conclusions: Due to the low incidence of cesarean scar pregnancies and the nonexistence of consensus regarding their treatment, this case report can improve understanding of these pregnancies, which could lead to the establishment of new guidelines.