Fertility and Sterility
Volume 91, Issue 6 , Pages 2623-2627 , June 2009

Uterine-preserving emergency surgery for cesarean scar pregnancies: another medical solution to an iatrogenic problem

  • Reuvit Halperin, M.D., Ph.D.

      Affiliations

    • Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University
    • Corresponding Author InformationReprint requests: Reuvit Halperin, M.D., Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, 70300, Israel (FAX: 972-8-9778026).
    • ,
  • David Schneider, M.D.

      Affiliations

    • Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University
    • ,
  • Sonia Mendlovic, M.D.

      Affiliations

    • Institute of Pathology, Assaf Harofe Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University
    • ,
  • Moty Pansky, M.D.

      Affiliations

    • Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University
    • ,
  • Arie Herman, M.D.

      Affiliations

    • Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University
    • ,
  • Ron Maymon, M.D.

      Affiliations

    • Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University

Received 16 December 2007 ,Revised 10 March 2008 ,Accepted 10 March 2008.

References 

  1. Maymon R, Halperin R, Mendlovic S, Schneider D, Herman A. Ectopic pregnancies in a caesarean scar: review of the medical approach to an iatrogenic complication. Hum Reprod Update. 2004;10:515–523
  2. Seow KM, Huang LW, Lin YH, Lin MY, Tsai YL, Hwang JL. A cesarean scar pregnancy: issues in management. Ultrasound Obstet Gynecol. 2004;23:247–253
  3. Smith A, Maxwell D, Ash A. Sonographic diagnosis of caesarean scar pregnancy at 16 weeks. J Clin Ultrasound. 2007;35:212–215
  4. Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis and management. Obstet Gynecol. 2006;107:1373–1377
  5. Einenkel J, Stumpp P, Kosling S, Horn LC, Hockel M. A misdiagnosed case of caesarean scar pregnancy. Arch Gynecol Obstet. 2005;271:178–181
  6. Maymon R, Halperin R, Mendlovic S, Schneider D, Vaknin Z, Herman A, et al. Ectopic pregnancies in caesarean section scars: the 8 year experience of one medical centre. Hum Reprod. 2004;19:1–7
  7. Seow KM, Cheng WC, Chuang J, Lee C, Tsai YL, Hwang JL. Methotrexate for cesarean scar pregnancy after in vitro fertilization and embryo transfer. J Reprod Med. 2000;45:754–757
  8. Godin PA, Bassil S, Donnez J. An ectopic pregnancy developing in a previous caesarian section scar. Fertil Steril. 1997;67:398–400
  9. Fylstra DL. Ectopic pregnancy within a cesarean scar: a review. Obstet Gynecol Surv. 2002;57:537–543
  10. Vial Y, Petignat P, Hohlfeld P. Pregnancy in a cesarean scar. Ultrasound Obstet Gynecol. 2000;16:592–593
  11. Stovall TS, Ling FW. Single-dose methotrexate: an expanded clinical trial. Am J Obstet Gynecol. 1993;168:1759–1765
  12. Fylstra DL, Pound-Chang T, Miller MG, Cooper A, Miller KM. Ectopic pregnancy within a cesarean delivery scar: a case report. Am J Obstet Gynecol. 2002;187:302–304
  13. Jurkovic D, Hillaby K, Woelfer B, Lawrence A, Salim R, Elson CJ. First trimester diagnosis and management of pregnancies implanted into the lower uterine segment cesarean section scar. Ultrasound Obstet Gynecol. 2003;21:220–227
  14. Deb S, Clewes J, Hewer C, Raine-Fenning N. The management of Cesarean scar ectopic pregnancy following treatment with methotrexate—a clinical challenge. Ultrasound Obstet Gynecol. 2007;30:889–892
  15. Arslan M, Pata O, Dilek TU, Aktas A, Aban M, Dilek S. Treatment of viable cesarean scar ectopic pregnancy with suction curettage. Int J Gynecol Obstet. 2005;89:163–166
  16. Wang CJ, Chao AS, Yuen LT, Wang CW, Soong YK, Lee CL. Endoscopic management of cesarean scar pregnancy. Fertil Steril. 2006;85:494–497
  17. Wang CJ, Yuen LT, Chao AS, Lee CL, Yen CF, Soong YK. Caesarean scar pregnancy successfully treated by operative hysteroscopy and suction curettage. Br J Obstet Gynaecol. 2005;112:839–840
  18. Lee CL, Wang CJ, Chao AS, Yen CF, Soong YK. Laparoscopic management of an ectopic pregnancy in a previous caesarean section scar. Hum Reprod. 1999;14:1234–1236
  19. Wang YL, Su TH, Chen HS. Operative laparoscopy for unruptured ectopic pregnancy in a caesarean scar. Br J Obstet Gynaecol. 2006;113:1035–1038
  20. Sugawara J, Senoo M, Chisaka H, Yaegashi N, Okamura K. Successful conservative treatment of a cesarean scar pregnancy with uterine artery embolization. Tohoku J Exp Med. 2005;206:261–265
  21. Yang MJ, Jeng MH. Combination of transarterial embolization of uterine arteries and conservative surgical treatment for pregnancy in a cesarean section scar. A report of 3 cases. J Reprod Med. 2003;48:213–216
  22. Ash A, Smith A, Maxwell D. Caesarean scar pregnancy. Br J Obstet Gynaecol. 2007;114:253–263
  23. Shih JC. Cesarean scar pregnancy: diagnosis with three dimensional (3D) ultrasound and 3D power Doppler. Ultrasound Obstet Gynecol. 2004;23:306–307

 R.H. has nothing to disclose. D.S. has nothing to disclose. S.M. has nothing to disclose. M.P. has nothing to disclose. A.H. has nothing to disclose. R.M. has nothing to disclose.

PII: S0015-0282(08)00592-X

doi: 10.1016/j.fertnstert.2008.03.021

Fertility and Sterility
Volume 91, Issue 6 , Pages 2623-2627 , June 2009

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