Caesarean Scar Pregnancy: A Single Center Experience

• Main Authors: Alev Özer, Abdullah Tok, Bülent Köstü
• Format: Article
• Language: English
• Published: Modestum Publishing LTD 2018-03-01
• Series: Journal of Clinical and Experimental Investigations
• Subjects: Ectopic pregnancy; caesarean scar pregnancy; methotrexate
• Online Access: http://jceionline.org/upload/sayi/40/JCEI-01441.pdf
• ISSN: 1309-8578; 1309-6621

Objective: To present the demographic and clinical characteristics and the treatment method of cases of caesarean scar pregnancy (CSP). Patients and Methods: A retrospective examination was made of cases diagnosed with CSP at the tertiary reference hospital of Sütçu Imam University between January 2015 and December 2017. Data were retrieved related to the demographic characteristics of the patients, ultrasonography (USG) findings and treatment procedures. Results: A total of 23 CSP cases were identified in the specified study period. The mean age of the patients was 31.2 ± 6.9 years, mean gravida was 4.4 ± 1.7, mean gestational age was 7.0 ± 1.1 weeks and the number of previous caesarean section (CS) deliveries was 2.0 ± 0.9. Intramuscular methotrexate (MTX) at a dose of 1mg/kg was applied to all the patients, then after 1 week, a dilatation and curettage (D&C) procedure. Before the MTX treatment, the initial serum beta-hCG value was determined as 15813.1 ± 12740.5 IU/mL. The hemoglobin (Hb) level was determined as 12.3 ± 1.4 before MTX treatment and 11.4 ± 0.6g/dL after the D&C procedure. Hysterectomy was not applied to any patient. CSP was determined at the rate of 8.0% of all ectopic pregnancies. Conclusion: CSP, which has shown an increase in recent years in parallel with CS rates, may cause bleeding and serious complications even as far as maternal mortality. CSP cases in our clinic were successfully treated with a combination of systemic MTX followed by D&C.