Successful Conservative Management of Cesarean Section Scar Pregnancy.

Lee, Hyun Chul; Lee, Soo Jin; Kwak, Dong Wook; Park, Yong Won; Kim, Young Han

Case Report

Korean Journal of Obstetrics & Gynecology 2006;49(9):1967-1976.
Published online September 1, 2006.

Successful Conservative Management of Cesarean Section Scar Pregnancy.

Hyun Chul Lee, Soo Jin Lee, Dong Wook Kwak, Yong Won Park, Young Han Kim

¹Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Korea. yhkim522@yumc.yonsei.ac.kr
²Institute of Women's Life Science, Seoul, Korea.

Abstract

A Cesarean section scar pregnancy is a rare but possibly life-threatening condition. The diagnosis is made mainly based on transvaginal ultrasonography. We used the Doppler and serial beta HCG in determining the severity and prognosis. Because of the rarity, universal treatment has not been established. In our cases, the severity of bleeding was independent of the level of beta HCG and the duration of amenorrhea. The shorter the interval from the previous cesarean section, the more severe the symptom, in such case, we were able to preserve fertility by uterine artery embolization. Cesarean section scar pregnancy can be managed conservatively with methotrexate injection. Based on our case review, we can conclude that it is very important that we choose the each therapeutic management based on her history and condition. In our review, we present four cases diagnosed with Cesarean section scar pregnancy all managed conservatively to preserve future fertility.

Key Words: Cesarean Section Scar, Ectopic Pregnancy, Conservative Management