DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20221459

Successful conservative management of viable caesarean scar pregnancy with systemically administered methotrexate followed by ultrasound guided ethanol ablation of gestational sac: a rare case report

Dharini Muthukrishnan, Prabha Janakiraman

Abstract


The incidence and diagnosis of caesarean scar pregnancy is on rise because of rising caesarean section rates. Though many modalities are available for its management, none seems to be superior and data regarding them are also lacking. Here we are presenting a rare case report of successful conservative management of viable caesarean scar pregnancy with systemic methotrexate followed by ultrasound guided ethanol ablation of gestational sac.


Keywords


Caesarean scar pregnancy, Serum beta human chorionic gonadotropin, Methotrexate, Ethanol ablation

Full Text:

PDF

References


Kakinuma T, Kakinuma K, Matsuda Y, Yanagida K, Kaijima H, Ohwada M. Successful Conservative Treatment of Cesarean Scar Ectopic Pregnancy with Local Injections of Absolute Ethanol. Gynecol Minim Invasive Ther. 2021 Apr 30;10(2):132-134. doi: 10.4103/GMIT.GMIT_125_19. PMID: 34040976; PMCID: PMC8140540.

Osada H, Teramoto S, Kaijima H, Segawa T, Miyauchi O, Nagaishi M, Shozu M, Kato K, Gomel V. A Novel Treatment for Cervical and Cesarean Section Scar Pregnancies by Transvaginal Injection of Absolute Ethanol to Trophoblasts: Efficacy in 19 Cases. J Minim Invasive Gynecol. 2019 Jan;26(1):129-134. doi: 10.1016/j.jmig.2018.04.021. Epub 2018 Apr 30. PMID: 29723645.

Cali G, Timor-Tritsch IE, Palacios- Jaraquemada J, et al. Outcome of cesarean scar pregnancy managed expectantly: systematic review and meta-analysis. Ultrasound Obstet Gynecol.2018. February; 51(2):169-175.doi:10.1002/jog.17568.

Kanat- Pektas M, Bodur S, Dunbar O, Bakir VL. Systematic review: what is the best first-line approach for cesarean section ectopic pregnancy? Taiwan J Obstet Gynecol. 2016. April;55(2):263-269. Doi:10.1016/j.tjog.2015.03.009

Williams Gynecology 4th edition

Berek & Novak’S Gynecology 16th edition