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Cesarean scar pregnancy: A case report with surgical management after initially effective conservative treatment.

TitleCesarean scar pregnancy: A case report with surgical management after initially effective conservative treatment.
Publication TypeJournal Article
Year of Publication2019
AuthorsTsakiridis, I., Chatzikalogiannis I., Mamopoulos A., Dagklis T., Tsakmakidis G., Athanasiadis A., & Kalogiannidis I.
JournalInt J Surg Case Rep
Volume65
Pagination238-241
Date Published2019
ISSN2210-2612
Abstract

INTRODUCTION: The incidence of cesarean scar pregnancies (CSPs) is increasing, possibly due to higher rates of cesarean sections. We report a case of a CSP with severe bleeding following initial conservative management, that was eventually treated surgically.PRESENTATION OF THE CASE: A 33-year old woman with history of one cesarean section presented with abdominal pain and amenorrhea and was diagnosed with CSP. Conservative management with methotrexate was chosen and the treatment was regarded as successful after the expected reduction in serum hCG levels. Four days after the hospital discharge, the patient was readmitted with hemodynamic instability and an emergency laparotomy was performed to remove the remaining trophoblastic tissue.DISCUSSION: A CSP may present as a threatened miscarriage, or remain asymptomatic through the first trimester. Medical treatment may be successful, however a close follow-up is needed even after a reduction in serum hCG levels.CONCLUSION: We report a case of CSP that, following an initial apparently "successful" treatment with methotrexate, required surgical management due to heavy bleeding.

DOI10.1016/j.ijscr.2019.11.002
Alternate JournalInt J Surg Case Rep
PubMed ID31734475
PubMed Central IDPMC6864124

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