Successful Management of Caesarean Scar Ectopic Pregnancies: A Report of Five Cases

Neena  Malhotra; Nilofar Noor; Piyush   Bansal; K. Aparna   Sharma

doi:10.18502/jri.v22i3.6723

Neena Malhotra Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
Nilofar Noor Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
Piyush Bansal Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Nagpur, India
K. Aparna Sharma Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India

DOI: https://doi.org/10.18502/jri.v22i3.6723

Keywords: Caesarean section, Ectopic pregnancy, Gestational sac, Methotrexate.

Abstract

Background: Cesarean section scar ectopic pregnancy (CSEP) is a rare and potentially life-threatening condition. A standardized management protocol is yet to be established owing to limited data available.

Case Presentation: In this paper, five cases of CSEP over a period of 18 months at a tertiary referral hospital, managed medically with methotrexate administered both systemically and into the gestational sac at the time of feticide with potassium chloride (KCL) are presented. Surgical management was the second line therapy when medical treatment failed.

Conclusion: With rising trends in cesarean deliveries, CSEP may be a challenge which requires close investigation regarding its diagnosis and treatment on the merits of case studies and available healthcare facilities.