Cesarean scar ectopic with ruptured corpus luteal cyst: a rare case report
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20200393Keywords:
Caesarean section, Ectopic pregnancy, Hysterectomy, Laparotomy, Ruptured corpus luteal cyst, Scar ectopic, Ultrasound diagnosisAbstract
Incidence of caesarean scar pregnancy (CSP) is increasing because of a rising number of caesarean sections. Prompt diagnosis of the condition is required to reduce associated morbidity. A high index of suspicion is required for women with a suggestive history of CSP. Ultrasound scan is the diagnostic tool of choice. Management options include medical, surgical and interventional radiology. Appropriate patient selection is important for optimal results. Major haemorrhage and hysterectomy are the main risks associated with CSP. Therefore, adequate counselling and availability of surgical expertise and blood transfusion should be part of a comprehensive management strategy. We are reporting a rare case of G3P2L1 with previous two lower caesarean deliveries diagnosed with caesarean scar ectopic based on clinical and ultrasound finding came with acute pain in abdomen with haemodynamically unstable with intraoperative finding s/o unruptured c scar pregnancy along with ruptured corpus luteal cyst leading to severe intra-abdominal bleeding. C-scar ectopic and corpus luteal cyst confirmed on histopathology.
References
Seow KM, Huang LW, Lin YH, Lin MY, Tsai YL, Hwang JL. Caesarean scar pregnancy: issues in management. Ultrasound Obstet Gynecol. 2004;23:247-53.
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 Caesarean section scar. Ultrasound Obstet Gynecol. 2003;21:220-7.
Rotas MA, Haberman S, Levgur M. Caesarean scar ectopic pregnancies: aetiology, diagnosis, and management. Obstet Gynecol. 2006;107:1373-81.
Fylstra DL. Ectopic pregnancy within a caesarean scar: a review. Obstet Gynecol Surv. 2002;57:537-43.
Ash A, Smith A. Maxwell. Caesarean scar pregnancy. BJOG. 2007;114:253-63.
Qian ZD, Guo QY, Huang LL. Identifying risk factors for recurrent caesarean scar pregnancy: a case-control study. Fertil Steril. 2014;102:129-34.
Ben Nagi J, Helmy S, Ofili-Yebovi D, Yazbek J, Sawyer E, Jurkovic D. Reproductive outcomes of women with a previous history of Caesarean scar ectopic pregnancies. Hum Reprod. 2007;22:2012-5.
Zhang Y, Gu Y, Wang JM, Li Y. Analysis of cases with caesarean scar pregnancy. J Obstet Gynaecol Res. 2013;39:195-202.
Wang CJ, Yuen LT, Yen CF, Lee CL, Soong YK. Three-dimensional power Doppler ultrasound diagnosis and laparoscopic management of a pregnancy in a previous caesarean scar. J Laparoendosc Adv Surg Tech. 2004;14:399-402.
Shish JC. Caesarean scar pregnancy: diagnosis with three-dimensional (3D) ultrasound with 3D power Doppler. Ultrasound Obstet Gynecol. 2004;23:306-7.
Timor-Tritsch IE, Monteagudo A, Santos R, Tsymbal T, Pineda G, Arslan AA. The diagnosis, treatment, and follow-up of caesarean scar pregnancy. Am J Obstet Gynecol. 2012;207:44.e1-13.
Koroglu M, Kayhan A, Soylu FN, Erol B, Schmid-Tannwald C, Gurses C, et al. MR imaging of ectopic pregnancy with an emphasis on unusual implantation sites. Jpn J Radiol. 2013;31:75-80.
Timor-Tritsch IE, Monteagudo A. Unforeseen consequences of the increasing rate of caesarean deliveries: early placenta accreta and caesarean scar pregnancy: a review. Am J Obstet Gynecol. 2012;207:14-29.
Deb S, Clewes J, Hewer C, Raine-Fenning N. The management of caesarean scar ectopic pregnancy following treatment with methotrexate - a clinical challenge. Ultrasound Obstet Gynecol. 2007;30:889-92.
