scholarly journals VP59.17: Lacunar‐like changes of the chorion: can it be a first trimester ultrasound sign in predicting worse clinical outcome in Caesarean scar pregnancy termination?

2020 ◽  
Vol 56 (S1) ◽  
pp. 318-319
Author(s):  
Z. Liu ◽  
Z. Shi ◽  
Y. Wei ◽  
Q. Dai ◽  
X. Liu
Keyword(s):  
Clinical Outcome ◽  
Pregnancy Termination ◽  
First Trimester ◽  
Caesarean Scar ◽  
Caesarean Scar Pregnancy ◽  
Ultrasound Sign ◽  
First Trimester Ultrasound

scholarly journals Combination of medical and surgical management in successful treatment of caesarean scar pregnancy: a case report series

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anda Pristavu ◽  
Angela Vinturache ◽  
Elena Mihalceanu ◽  
Radu Pintilie ◽  
Mircea Onofriescu ◽  
...  
Keyword(s):  
Surgical Management ◽  
Pregnancy Termination ◽  
Color Doppler ◽  
Transvaginal Ultrasound ◽  
Case Series ◽  
First Trimester ◽  
The Body ◽  
Inadequate Response ◽  
Caesarean Scar ◽  
Caesarean Scar Pregnancy

Abstract Background There is no clear consensus on the management of caesarean scar pregnancy (CSP), a complex and life-threatening condition. The objective of this study was to present a novel approach to management of CSP that combines medical therapy of multidose methotrexate and mifepristone with active surgical management by uterine curettage and consecutive local haemostasis. Case presentation We report on a prospective case series of six women with first trimester pregnancy, in whom the diagnosis of CSP was confirmed by 2D and color Doppler transvaginal ultrasound and serial hormone chorionic gonadotropin (hCG) testing. Women were between 23 and 36 years old and had at least one previous delivery by caesarean. At admission, gestational age ranged between 6 to 14 weeks, and serum hCG levels between 397 and 23,000 mUI/ml. Upon decision of pregnancy termination, medical management was undertaken in all cases and 1 mg/kg systemic Methotrexate was administered between 1 and 5 daily doses. Mifepristone was part of the treatment in cases with live pregnancy. Surgical management was employed for the cases were an embryo was seen by ultrasound, being prompted by inadequate response to Methotrexate and/or signs of miscarriage with vaginal bleeding. Curettage combined with local isthmic balloon or vaginal pack tamponade prevented further complications. High treatment rates with preservation of fertility was achieved in all patients except one who underwent hysterectomy for invasive placentation. Ultrasound and hCG levels surveillance ensured that the resolution of pregnancy was achieved. Conclusion Women with history of delivery by caesarean section should be carefully monitored in future pregnancies for prompt diagnosis of CSP. Early diagnosis of CSP allows selection of successful conservative therapy. Through this case series we contribute with our experience to the body of knowledge about the management of this serious complication of early pregnancy.

scholarly journals VP59.45: Sonographic evaluation and classification of a Caesarean scar pregnancy in first trimester

2020 ◽  
Vol 56 (S1) ◽  
pp. 326-326
Author(s):  
I.M. Jordans ◽  
R.A. Leeuw ◽  
C.M. Bilardo ◽  
T. Van den Bosch ◽  
T. Bourne ◽  
...  
Keyword(s):  
First Trimester ◽  
Caesarean Scar ◽  
Sonographic Evaluation ◽  
Caesarean Scar Pregnancy

scholarly journals OP01.03: Accuracy of sonographic features in diagnosing Caesarean scar pregnancy during the early first trimester

2021 ◽  
Vol 58 (S1) ◽  
pp. 59-59
Author(s):  
L. Chew ◽  
E. Chua ◽  
P. Lombardo ◽  
M. Goodyear ◽  
S. Teo
Keyword(s):  
First Trimester ◽  
Caesarean Scar ◽  
Caesarean Scar Pregnancy

scholarly journals Ruptured Ectopic Pregnancy in Caesarean Section Scar: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Kamal Singh ◽  
Anjali Soni ◽  
Shelly Rana
Keyword(s):  
Case Report ◽  
Caesarean Section ◽  
Ectopic Pregnancy ◽  
Maternal Morbidity ◽  
Rare Case ◽  
First Trimester ◽  
Transvaginal Sonography ◽  
Caesarean Scar ◽  
Future Fertility ◽  
Caesarean Scar Pregnancy

Pregnancy implantation within previous caesarean scar is one of the rarest locations for an ectopic pregnancy. Incidence of caesarean section is increasing worldwide and with more liberal use of transvaginal sonography, more cases of caesarean scar pregnancy are being diagnosed in early pregnancy thus allowing preservation of uterus and fertility. However, a delay in either diagnosis or treatment can lead to uterine rupture, hysterectomy, and significant maternal morbidity. We are reporting a rare case of first trimester caesarean scar pregnancy with viable fetus in the process of rupture, where uterine repair could be done, thus preserving the future fertility.

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