Scar Pregnancy: A Case Series Involving Two Medical College Hospitals in West Bengal
Indranil Dutta, Abhijit Haldar, Mainak Nath
Citation Information :
Dutta I, Haldar A, Nath M. Scar Pregnancy: A Case Series Involving Two Medical College Hospitals in West Bengal. J South Asian Feder Obs Gynae 2020; 12 (1):51-58.
Scar pregnancy is increasing day by day due to the increasing number of cesarean section as well as operative intervention on uterus. Though there are improved diagnostic modalities in recent era, there is certain a deficiency of knowledge of specific diagnosis and treatment among the obstetricians and radiologists. Only few case reports are available online, but there are more cases of scar pregnancy which are underdiagnosed leading to high morbidity and even mortality. In this case series, we report 11 cases of scar ectopic pregnancy with different presenting features and treatment. Though in our case series there is no mortality, morbidity is seen to be high. We tried to increase the suspicion of scar ectopic pregnancy among obstetricians and radiologists to reduce these morbidities, especially in the cases of previous cesarean section and previous myomectomies.
Lai YM, Lee JD. An ectopic pregnancy embedded in the myometrium of a previous caesarean section. Acta Obstet Gynaecol Scand 1995;74(7):573–576. DOI: 10.3109/00016349509024394.
Tamada S, Masuyama H, Maki J, et al. Successful pregnancy located in a uterine cesarean scar: a case report. Case Rep Womens Health 2017;14:8–10. DOI: 10.1016/j.crwh.2017.03.003.
Seow KM, Huang LW, Lin YH, et al. Cesarean scar pregnancy: issues in management. Ultrasound Obstet Gynecol 2004;23(3):247–253. DOI: 10.1002/uog.974.
Ravikanth R. Intramyometrial gestation: a rare localization of ectopic pregnancy. Trop J Obstet Gynaecol 2017;34(1):73–75. DOI: 10.4103/TJOG.TJOG_2_17.
Kambo I, Bedi N, Dhillon BS, et al. A critical appraisal of cesarean section rates at teaching hospital in India. Int J Gynaecol Obstet 2002;79:151–158. DOI: 10.1016/S0020-7292(02)00226-6.
Akolekar R, Pandit SN, Rao BS. The cesarean birth FOGSI publications. 1st ed., National Book Depot; 2010. p. 1–3.
Godin PA, Bassil S, Donnez J. An ectopic pregnancy developing in a previous caesarean section scar. Fertil Steril 1997;67(2):398–400. DOI: 10.1016/S0015-0282(97)81930-9.
Larsen JV, Solomon MH. Pregnancy in a uterine scar sacculus—an unusual cause of postabortal haemorrhage. S Afr Med J 1978;53(4):142–143.
Feichtinger W, Kemeter P. Conservative treatment of ectopic pregnancy by transvaginal aspiration under sonographic control and methotrexate injection. Lancet 1987;1(8529):381–382. DOI: 10.1016/S0140-6736(87)91750-8.
Yankowitz J, Leake J, Huggins G. Cervical ectopic pregnancy; review of the literature and report of a case treated by single dose methotrexate therapy. Obstetr Gynaecol Surv 1990;45(7):405–414. DOI: 10.1097/00006254-199007000-00001.
Pirtea L, Balint O, Secosan C, et al. Laparoscopic resection of cesarean scar ectopic pregnancy after unsuccessful systemic methotrexate treatment. J Minim Invasive Gynecol 2019;26(3):399–400. DOI: 10.1016/j.jmig.2018.06.003, Epub 2018 Jun 8.
