Recurrent ectopic pregnancy in a cesarean scar

Marium G. Holland, Jessica L Bienstock

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Ectopic pregnancy in a cesarean scar is a rare but well-recognized potential complication of cesarean delivery. Multiple risk factors exist, including prior uterine surgery, a history of uterine infections such as endomyometritis, and a brief interval between uterine surgery and subsequent conception. It is important to recognize such cases early, due to the risk for uterine rupture and catastrophic hemorrhage at early gestational ages. CASE: This patient presented for a dating ultrasound examination at 4 6/7 weeks of gestation. Her history was significant for an ectopic pregnancy in her cesarean scar 3 years prior that was managed by surgical resection. The initial ultrasound examination was suspicious for a recurrent ectopic pregnancy in her cesarean scar. The diagnosis was confirmed on repeat ultrasonography at 6 weeks of gestation. She was treated with methotrexate, and the pregnancy resolved without complication. CONCLUSION: Ectopic pregnancy in a cesarean scar is an important diagnosis to consider in a woman who has had a history of cesarean delivery and whose early ultrasonography shows a thin, lower uterine segment or a low implantation site. If the diagnosis is not clear on initial ultrasound examination, the patient should be followed up with serial ultrasound examinations. Once recognized, patients with this complication may be treated either surgically or medically as indicated by the clinical situation.

Original languageEnglish (US)
Pages (from-to)541-545
Number of pages5
JournalObstetrics and Gynecology
Volume111
Issue number2 PART 2
DOIs
Publication statusPublished - Feb 2008

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ASJC Scopus subject areas

  • Obstetrics and Gynecology

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