Laparoscopic resection and repair of caesarean scar pregnancy
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20232965Keywords:
Ectopic pregnancy, Caesarean scar pregnancy, Laparoscopic repairAbstract
The presented work is case series over 2 years of caesarean scar pregnancy over 2 years from January 2020 to January 2022 in Zinat Alhayat hospital of maternity in Benha city Egypt. Cases recruited from those attending Zeinat Alhayat maternity hospital in Benha and all case proved to have caesarean scar pregnancy by ultrasonography and quantitative HCG the total number of cases were 15 over a period of two years, most of patients complained about abnormal uterine bleeding in the first trimester with abnormal abdominal pain, all cases prepared for laparoscopy in Zinat Alyayat hospital in Benha and a written consent taken then with general anesthesia pelvis and abdomen explored by laparoscopy and the site of the scar opened with a hook with the aid of a traumatic grasper and then sac evacuated and the old scar resected by laparoscopic scissor. Regarding epidemiological data of patients there were no statistically significant difference in age body weight age or the amount of pain by facial analogue scale of pain. All patients saved and laparoscopy done with an average time of 45 min with no operative or postoperative complications, only one of the cases with severe bleeding required blood transfusion of 2 units of blood because HB was 7.8 g/dl, so laparoscopic treatment of caesarean scar pregnancies is a good option for patients with short operative time and good outcomes without complications.
References
Birch Petersen K, Hoffmann E, Rifbjerg Larsen C, Svarre Nielsen H. Cesarean scar pregnancy: a systematic review of treatment studies. Fertil Steril. 2016;105(4):958-67.
Jurkovic D, Hillaby K, Woelfer B, Lawrence A, Salim R, Elson CJ. Cesarean scar pregnancy. Ultrasound Obstet Gynecol. 2003;21(3):310.
Calì G, Timor-Tritsch IE, Palacios-Jaraquemada J, Monteaugudo A, Buca D, Forlani F, et al. Outcome of Cesarean scar pregnancy managed expectantly: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2018;51(2):169-75.
Litwicka K, Greco E. Caesarean scar pregnancy: a review of management options. Curr Opin Obstet Gynecol. 2013;25(6):456-61.
Zhang Y, Zhang Z, Liu X, Zhang L, Hong F, Lu M. Risk factors for massive hemorrhage during the treatment of cesarean scar pregnancy: a systematic review and meta-analysis. Arch Gynecol Obstet. 2021;303(2):321-8.
Ghezzi F, Laganà D, Franchi M, Fugazzola C, Bolis P. Conservative treatment by chemotherapy and uterine arteries embolization of a cesarean scar pregnancy. Eur J Obstet Gynecol Reprod Biol. 2002;103(1):88-91.
Jayaram P, Okunoye G, Al Ibrahim AA, Ghani R, Kalache K. Expectant management of caesarean scar ectopic pregnancy: a systematic review. J Perinat Med. 2018;46(4):365-72.
Deans R, Abbott J. Hysteroscopic management of cesarean scar ectopic pregnancy. Fertil Steril. 2010;93(6):1735-40.
Kaur R, Goel B, Sehgal A, Goyal P, Mehra R. Feticide with intracardiac potassium chloride to reduce risk of hemorrhage in medical termination of pregnancy. J Gynecol Women Healthc. 2018;1(1):1-4.
Jayaram PM, Okunoye GO, Konje J. Caesarean scar ectopic pregnancy: diagnostic challenges and management options. Obstet Gynaecol. 2017;19(1):13-20.
Seow KM, Wang PH, Huang LW, Hwang JL. Transvaginal sono-guided aspiration of gestational sac concurrent with a local methotrexate injection for the treatment of unruptured cesarean scar pregnancy. Arch Gynecol Obstet. 2013;288(2):361-6.
Sadeghi H, Rutherford T, Rackow BW, Campbell KH, Duzyj CM, Guess MK, et al. Cesarean scar ectopic pregnancy: case series and review of the literature. Am J Perinatol. 2010;27(2):111-20.
Cheung VY. Local Methotrexate Injection as the First-line Treatment for Cesarean Scar Pregnancy: Review of the Literature. J Minim Invasive Gynecol. 2015;22(5):753-8.
Petersen K, Hoffmann E, Rifbjerg Larsen C, Svarre Nielsen H. Cesarean scar pregnancy: a systematic review of treatment studies. Fertil Steril. 2016;105(4):958-67.
Ghezzi F, Laganà D, Franchi M, Fugazzola C, Bolis P. Conservative treatment by chemotherapy and uterine arteries embolization of a cesarean scar pregnancy. Eur J Obstet Gynecol Reprod Biol. 20 Litwicka K, Greco E. Caesarean scar pregnancy: a review of management options. Curr Opin Obstet Gynecol. 2013;25(6):456;103(1):88-91.
Litwicka K, Greco E. Caesarean scar pregnancy: a review of management options. Curr Opin Obstet Gynecol. 2013;25(6):456-61.