Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 12 , ISSUE 2 ( March-April, 2020 ) > List of Articles

CASE REPORT

Ruptured Scar Ectopic Pregnancy: A Near Miss Case

Shraddha A Mevada

Citation Information : Mevada SA. Ruptured Scar Ectopic Pregnancy: A Near Miss Case. J South Asian Feder Obs Gynae 2020; 12 (2):111-112.

DOI: 10.5005/jp-journals-10006-1766

License: CC BY-NC 4.0

Published Online: 16-12-2020

Copyright Statement:  Copyright © 2020; The Author(s).


Abstract

Aim: Successful management of near miss case of ruptured scar ectopic pregnancy. Background: Cesarean scar pregnancy (CSP) is an uncommon and potentially life-threatening form of ectopic pregnancy. The incidence of CSP is estimated at between 0.05 and 0.4% of all pregnancies and is expected to increase in prevalence in parallel with rising cesarean section rates. Case description: We present a case report of 30-year-old gravida 2 para 1 live 1 with previous 1 LSCS done 2 years back i/v/o fetal distress with 8.5 weeks. By date, with pain in abdomen since 2 days which aggravated since 6 hours followed by per vaginal spotting since 1 day came in emergency to our hospital. General condition of the patient on arrival was pulse 140 beats per minute, blood pressure 90/60 mm Hg, per abdominal examination was tenderness present in lower abdomen, per vaginal examination revealed uterus bulky, cervical os admits tip of finger, right fornical tenderness present, and bleeding present. Conclusion: On emergency laparotomy, after opening the abdominal cavity, ruptured scar ectopic pregnancy was noted, with 4 × 3 cm in dimension with hemoperitoneum with 300 mL of blood, and 80 g of blood clots were evacuated. Excision of scar with adherent ectopic tissue was done followed by resuturing of remnant uterine wall with continuous interlocking manner with polyglactin 910. Patient was transfused blood accordingly, and postoperative period was uneventful. Clinical significance: Although clinical and ultrasonography findings can mislead us, ruptured scar ectopic pregnancy should always kept in mind with proper counseling and possibility of torrential hemorrhage and hysterectomy along with availability of senior skilled obstetrician around.


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