scholarly journals Conservative Management of Cesarean Scar Ectopic Pregnancy with Fetal Heart Activity and a Very Highβ-hCG

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Rodney McLaren ◽  
Sandra McCalla ◽  
Mohamad Irani
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Fetal Heart ◽  
Heart Activity ◽  
Artery Embolization ◽  
Rare Type ◽  
Prenatal Visit ◽  
Cesarean Scar ◽  
Very High

Cesarean scar ectopic pregnancy (CSP) is a rare type of ectopic pregnancy that is growing in incidence. The diagnosis of most CSP occurs when patients present in unstable conditions requiring surgical management and leading sometimes to hysterectomy. It has been shown that medical management is a safe option for early diagnosed hemodynamically stable CSP. However, no cases of CSP withβ-hCG higher than 62,000 IU/L, conservatively treated, have been reported. We report the case of a 29-year-old patient who presented for her first prenatal visit at 13-week gestation and was diagnosed with CSP with present fetal heart tones and a quantitativeβ-hCG of 144,337 IU/L. She was treated with bilateral uterine artery embolization and systemic methotrexate. Herβ-hCG significantly decreased and became undetectable within 10 weeks. We propose that patients with CSP with very highβ-hCG and fetal heart activity can be offered conservative or fertility preserving management.

scholarly journals Successful Conservative Treatment of a Cesarean Scar Pregnancy with Systemically Administered Methotrexate and Subsequent Dilatation and Curettage: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Anis Fadhlaoui ◽  
Mohamed Khrouf ◽  
Khaled Khémiri ◽  
Kais Nouira ◽  
Anis Chaker ◽  
...  
Keyword(s):  
Case Report ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Artery Embolization ◽  
Cesarean Scar Pregnancy ◽  
Rare Type ◽  
Cesarean Scar ◽  
Dilatation And Curettage ◽  
Severe Hemorrhage ◽  
The Cost

Cesarean scar pregnancy is a rare type of ectopic pregnancy associated with severe complications such as uterine rupture, uncontrollable bleeding which may lead to hysterectomy, and definitive infertility. Many therapeutic options are available such as Dilatation & Curetage, excision of trophoblastic tissues using either laparotomy or laparoscopy, systemically administered Methotrexate, and more recently uterine artery embolization. The use of Methotrexate sometimes required laparotomy later because of severe hemorrhage. Through this paper, we demonstrated that viable cesarean scar pregnancy can be managed safely by systemically delivered Methotrexate at the cost of a prolonged followup.

scholarly journals Risk factors for poor hemostasis of prophylactic uterine artery embolization before curettage in cesarean scar pregnancy

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096437
Author(s):  
Hongan Tian ◽  
Shunzhen Li ◽  
Wanwan Jia ◽  
Kaihu Yu ◽  
Guangyao Wu
Keyword(s):  
Risk Factors ◽  
Blood Supply ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Embolic Agent ◽  
Artery Embolization ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Hemorrhage Volume ◽  
Gestational Sac

Objective To observe the hemostatic effect of prophylactic uterine artery embolization (UAE) in patients with cesarean scar pregnancy (CSP) and to examine the risk factors for poor hemostasis. Methods Clinical data of 841 patients with CSP who underwent prophylactic UAE and curettage were retrospectively analyzed to evaluate the hemorrhage volume during curettage. A hemorrhage volume ≥200 mL was termed as poor hemostasis. The risk factors of poor hemostasis were analyzed and complications within 60 days postoperation were recorded. Results Among the 841 patients, 6.30% (53/841) had poor postoperative hemostasis. The independent risk factors of poor hemostasis were gestational sac size, parity, embolic agent diameter (>1000 μm), multivessel blood supply, and incomplete embolization. The main postoperative complications within 60 days after UAE were abdominal pain, low fever, nausea and vomiting, and buttock pain, with incidence rates of 71.22% (599/841), 47.44% (399/841), 39.12% (329/841), and 36.39% (306/841), respectively. Conclusions Prophylactic UAE before curettage in patients with CSP is safe and effective in reducing intraoperative hemorrhage. Gestational sac size, parity, embolic agent diameter, multivessel blood supply, and incomplete embolization of all arteries supplying blood to the uterus are risk factors of poor hemostasis.

scholarly journals Cesarean Scar Pregnancy Treated by Artery Embolization Combined with Diode Laser: A Novel Approach for a Rare Disease

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 411
Author(s):  
Felice Sorrentino ◽  
Vincenzo De Feo ◽  
Guglielmo Stabile ◽  
Raffaele Tinelli ◽  
Maurizio Nicola D’Alterio ◽  
...  
Keyword(s):  
Diode Laser ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Artery Embolization ◽  
Artery Ligation ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Dilation And Curettage ◽  
Management Protocol ◽  
Future Fertility

Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy which represents a consequence of a previous cesarean section. It is associated with major maternal morbidity and mortality and has potential implications on future fertility. Because of possible serious complications, CSP should be swiftly diagnosed and treated. There is no management protocol for this rare, life-threatening condition, and each patient should be evaluated individually. Several types of conservative treatment have been used to treat cesarean scar pregnancy: dilation and curettage (D&C), excision of trophoblastic tissues, local or systemic administration of methotrexate, bilateral hypogastric artery ligation, and selective uterine artery embolization with curettage and/or methotrexate administration. In our study we present a cesarean scar pregnancy of a 40-year-old woman who was treated with angiographic uterine artery embolization (UAE) followed by hysteroscopic diode laser resection. Our combined UAE–hysteroscopic laser surgery appears to offer an effective, safe, and minimally invasive surgical treatment.

scholarly journals Uterine artery embolization combined with local infusion of methotrexate and 5- fluorouracil in treating ectopic pregnancy

Medicine ◽  
2018 ◽  
Vol 97 (5) ◽  
pp. e9722 ◽  
Author(s):  
Juan Gao ◽  
Xiaobing Li ◽  
Jianwei Chen ◽  
Weidong Gong ◽  
Kun Yue ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Artery Embolization
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