A Case of Successful Treatment with Methotrexate Injection on Intramural Pregnancy Embedded in the Myometrium of Previous Cesarean Section Scar.

Kim, Byeong Seon; Kim, Hyeong Ho; Gu, Jin Young; Hong, Sun Woong; Sun, Jin Gyu; Kee, Kwang Soo

Case Report

Korean Journal of Obstetrics & Gynecology 2003;46(9):1767-1770.
Published online September 1, 2003.

A Case of Successful Treatment with Methotrexate Injection on Intramural Pregnancy Embedded in the Myometrium of Previous Cesarean Section Scar.

Byeong Seon Kim, Hyeong Ho Kim, Jin Young Gu, Sun Woong Hong, Jin Gyu Sun, Kwang Soo Kee

Department of Obstetrics and Gynecology, Kwangju Christian Hospital, Kwangju, Korea.

Abstract

Intramural pregnancy implanting in the previous cesarean section scar is one of the rarest form of an ectopic pregnancy and probably the most dangerous form because of its risk of rupture and hemorrhage. For its sonographic diagnosis, the gestational sac should be in the anterior wall of uterine isthmic portion, there should be no myometrium between bladder and gestational sac, and it should be verified that uterine cavity and cervix should be isolated from gestational sac. For young patients who wish to maintain their fertility, an earlier diagnosis and more conservative treatment are desirable. We have recently experienced a case of intramural pregnancy implanting in the scar of cesarean section, treated with systemic methotrexate injection. So, we report this case with a brief review of the literature.

Key Words: Intramural pregnancy, Cesarean section scar, Methotrexate