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Published in: Journal of Medical Case Reports 1/2018

Open Access 01-12-2018 | Case report

Normal vaginal delivery at term after expectant management of heterotopic caesarean scar pregnancy: a case report

Published in: Journal of Medical Case Reports | Issue 1/2018

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Abstract

Background

Heterotopic pregnancy with a combination of a caesarean scar pregnancy and an intrauterine pregnancy is rare and has potentially life-threatening complications.

Case presentation

We describe the case of a 27-year-old white woman who had experienced an emergency caesarean delivery at 39 weeks for fetal distress with no postpartum complications. This is a report of the successful expectant management of a heterotopic scar pregnancy. The gestational sac implanted into the scar area was non-viable. The woman was treated expectantly and had a normal vaginal delivery at 37 weeks of gestation.

Conclusion

Expectant management under close monitoring can be appropriate in small non-viable heterotopic caesarean scar pregnancies.
Literature
1.
go back to reference 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 Cesarean section scar. Ultrasound Obstet Gynecol. 2003;21(3):220–7.CrossRefPubMed 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 Cesarean section scar. Ultrasound Obstet Gynecol. 2003;21(3):220–7.CrossRefPubMed
2.
go back to reference Osborn DA, Williams TR, Craig BM. Cesarean scar pregnancy: sonographic and magnetic resonance imaging findings, complications, and treatment. J Ultrasound Med. 2012;31:1449–56.CrossRefPubMed Osborn DA, Williams TR, Craig BM. Cesarean scar pregnancy: sonographic and magnetic resonance imaging findings, complications, and treatment. J Ultrasound Med. 2012;31:1449–56.CrossRefPubMed
3.
go back to reference Uysal F, Usal A, Adam G. Cesarean scar pregnancy: diagnosis, management, and follow-up. J Ultrasound Med. 2013;32:1295–300.CrossRefPubMed Uysal F, Usal A, Adam G. Cesarean scar pregnancy: diagnosis, management, and follow-up. J Ultrasound Med. 2013;32:1295–300.CrossRefPubMed
4.
go back to reference Litwicka K, Greco E. Caesarean scar pregnancy: a review of management options. Curr Opin Obstet Gynecol. 2011;23:415–21.CrossRefPubMed Litwicka K, Greco E. Caesarean scar pregnancy: a review of management options. Curr Opin Obstet Gynecol. 2011;23:415–21.CrossRefPubMed
5.
go back to reference Jordan RL, Wilson JG, Schumacher HJ. Embryotoxicity of the folate antagonist methotrexate in rats and rabbits. Teratology. 1977;15(1):73–9.CrossRefPubMed Jordan RL, Wilson JG, Schumacher HJ. Embryotoxicity of the folate antagonist methotrexate in rats and rabbits. Teratology. 1977;15(1):73–9.CrossRefPubMed
6.
go back to reference Timor-Tritsch IE. Is it safe to use methotrexate for selective injection in heterotopic pregnancy? Am J Obstet Gynecol. 1998;178:193–4.PubMed Timor-Tritsch IE. Is it safe to use methotrexate for selective injection in heterotopic pregnancy? Am J Obstet Gynecol. 1998;178:193–4.PubMed
7.
go back to reference Timor-Tritsch IE, Monteagudo A. Unforeseen consequences of the increasing rate of cesarean deliveries: early placenta accreta and cesarean scar pregnancy. A review. Am J Obstet Gynecol. 2012;207(1):14–29.CrossRefPubMed Timor-Tritsch IE, Monteagudo A. Unforeseen consequences of the increasing rate of cesarean deliveries: early placenta accreta and cesarean scar pregnancy. A review. Am J Obstet Gynecol. 2012;207(1):14–29.CrossRefPubMed
8.
go back to reference Mohammed ABF, Farid I, Ahmed B, Ghany EA. Obstetric and neonatal outcome of multifetal pregnancy reduction. Middle East Fertil Soc J. 2015;20(3):176–81.CrossRef Mohammed ABF, Farid I, Ahmed B, Ghany EA. Obstetric and neonatal outcome of multifetal pregnancy reduction. Middle East Fertil Soc J. 2015;20(3):176–81.CrossRef
10.
go back to reference Michaels AY, Washburn EE, Pocius KD, Benson CB, Doubilet PM, Carusi DA. Outcome of cesarean scar pregnancies diagnosed sonographically in the first trimester. J Ultrasound Med. 2015;34(4):595–9.CrossRefPubMed Michaels AY, Washburn EE, Pocius KD, Benson CB, Doubilet PM, Carusi DA. Outcome of cesarean scar pregnancies diagnosed sonographically in the first trimester. J Ultrasound Med. 2015;34(4):595–9.CrossRefPubMed
11.
go back to reference Salomon LJ, Fernandez H, Chauveaud A, Doumerc S, Frydman R. Successful management of a heterotopic Caesarean scar pregnancy: potassium chloride injection with preservation of the intrauterine gestation: case report. Hum Reprod. 2003;18(1):189–91.CrossRefPubMed Salomon LJ, Fernandez H, Chauveaud A, Doumerc S, Frydman R. Successful management of a heterotopic Caesarean scar pregnancy: potassium chloride injection with preservation of the intrauterine gestation: case report. Hum Reprod. 2003;18(1):189–91.CrossRefPubMed
12.
go back to reference Monteagudo A, Minior VK, Stephenson C, Monda S, Timor-Tritsch IE. Non-surgical management of live ectopic pregnancy with ultrasound-guided local injection: a case series. Ultrasound Obstet Gynecol. 2005;25(3):282–8.CrossRefPubMed Monteagudo A, Minior VK, Stephenson C, Monda S, Timor-Tritsch IE. Non-surgical management of live ectopic pregnancy with ultrasound-guided local injection: a case series. Ultrasound Obstet Gynecol. 2005;25(3):282–8.CrossRefPubMed
13.
go back to reference Wang CJ, Chao AS, Yuen LT, Wang CW, Soong YK, Lee CL. Endoscopic management of cesarean scar pregnancy. Fertil Steril. 2006;85(2):494.e1-4.CrossRefPubMed Wang CJ, Chao AS, Yuen LT, Wang CW, Soong YK, Lee CL. Endoscopic management of cesarean scar pregnancy. Fertil Steril. 2006;85(2):494.e1-4.CrossRefPubMed
15.
go back to reference Demirel LC, Bodur H, Selam B, Lembet A, Ergin T. Laparoscopic management of heterotopic cesarean scar pregnancy with preservation of intrauterine gestation and delivery at term: case report. Fertil Steril. 2009;91(4):1293.e5-7.CrossRefPubMed Demirel LC, Bodur H, Selam B, Lembet A, Ergin T. Laparoscopic management of heterotopic cesarean scar pregnancy with preservation of intrauterine gestation and delivery at term: case report. Fertil Steril. 2009;91(4):1293.e5-7.CrossRefPubMed
Metadata
Title
Normal vaginal delivery at term after expectant management of heterotopic caesarean scar pregnancy: a case report
Publication date
01-12-2018
Published in
Journal of Medical Case Reports / Issue 1/2018
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-018-1713-0

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