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Abruptio Placentae in Subsequent Pregnancy after Conservative Management of Hemorrhagic Cesarean Scar Pregnancy by Transcatheter Arterial Chemoembolization

INTRODUCTION: Cesarean scar pregnancy is a rare but dangerous type of ectopic pregnancy in which implantation occurs within the fibrous tissue of a cesarean scar defect. Conservative management of cesarean scar pregnancy is challenging, especially when future fertility preservation is a significant...

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Autores principales: Takeda, Akihiro, Imoto, Sanae, Nakamura, Hiromi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Libertas Academica 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747996/
https://www.ncbi.nlm.nih.gov/pubmed/23997578
http://dx.doi.org/10.4137/CCRep.S12744
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author Takeda, Akihiro
Imoto, Sanae
Nakamura, Hiromi
author_facet Takeda, Akihiro
Imoto, Sanae
Nakamura, Hiromi
author_sort Takeda, Akihiro
collection PubMed
description INTRODUCTION: Cesarean scar pregnancy is a rare but dangerous type of ectopic pregnancy in which implantation occurs within the fibrous tissue of a cesarean scar defect. Conservative management of cesarean scar pregnancy is challenging, especially when future fertility preservation is a significant concern. Furthermore, reports on significant maternal morbidity in subsequent pregnancies after successful conservative management of cesarean scar pregnancy are limited. CASE REPORT: A 31-year-old woman with previous history of 2 cesarean sections transferred due to massive uterine hemorrhage 7 weeks after dilatation and curettage performed under the diagnosis of missed abortion at 7 weeks of gestation. Cesarean scar pregnancy was diagnosed and was conservatively managed by emergent transcatheter arterial chemoembolization (TACE) followed by multiple doses of systemic methotrexate administration. Seven months after TACE, she spontaneously conceived. At 36 weeks and 5 days of pregnancy, emergency cesarean section was performed due to sudden massive hemorrhage. Abruptio placentae was diagnosed when hysterotomy was performed. After manual removal of the placenta, a healthy infant was delivered. The postoperative course was uneventful. CONCLUSION: The pregnancy course should be carefully monitored for early detection of maternal morbidity associated with placental abnormalities to achieve successful outcome in subsequent gestations after conservative management of cesarean scar pregnancy.
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spelling pubmed-37479962013-08-30 Abruptio Placentae in Subsequent Pregnancy after Conservative Management of Hemorrhagic Cesarean Scar Pregnancy by Transcatheter Arterial Chemoembolization Takeda, Akihiro Imoto, Sanae Nakamura, Hiromi Clin Med Insights Case Rep Case Report INTRODUCTION: Cesarean scar pregnancy is a rare but dangerous type of ectopic pregnancy in which implantation occurs within the fibrous tissue of a cesarean scar defect. Conservative management of cesarean scar pregnancy is challenging, especially when future fertility preservation is a significant concern. Furthermore, reports on significant maternal morbidity in subsequent pregnancies after successful conservative management of cesarean scar pregnancy are limited. CASE REPORT: A 31-year-old woman with previous history of 2 cesarean sections transferred due to massive uterine hemorrhage 7 weeks after dilatation and curettage performed under the diagnosis of missed abortion at 7 weeks of gestation. Cesarean scar pregnancy was diagnosed and was conservatively managed by emergent transcatheter arterial chemoembolization (TACE) followed by multiple doses of systemic methotrexate administration. Seven months after TACE, she spontaneously conceived. At 36 weeks and 5 days of pregnancy, emergency cesarean section was performed due to sudden massive hemorrhage. Abruptio placentae was diagnosed when hysterotomy was performed. After manual removal of the placenta, a healthy infant was delivered. The postoperative course was uneventful. CONCLUSION: The pregnancy course should be carefully monitored for early detection of maternal morbidity associated with placental abnormalities to achieve successful outcome in subsequent gestations after conservative management of cesarean scar pregnancy. Libertas Academica 2013-08-06 /pmc/articles/PMC3747996/ /pubmed/23997578 http://dx.doi.org/10.4137/CCRep.S12744 Text en © 2013 the author(s), publisher and licensee Libertas Academica Ltd. This is an open access article published under the Creative Commons CC-BY-NC 3.0 license.
spellingShingle Case Report
Takeda, Akihiro
Imoto, Sanae
Nakamura, Hiromi
Abruptio Placentae in Subsequent Pregnancy after Conservative Management of Hemorrhagic Cesarean Scar Pregnancy by Transcatheter Arterial Chemoembolization
title Abruptio Placentae in Subsequent Pregnancy after Conservative Management of Hemorrhagic Cesarean Scar Pregnancy by Transcatheter Arterial Chemoembolization
title_full Abruptio Placentae in Subsequent Pregnancy after Conservative Management of Hemorrhagic Cesarean Scar Pregnancy by Transcatheter Arterial Chemoembolization
title_fullStr Abruptio Placentae in Subsequent Pregnancy after Conservative Management of Hemorrhagic Cesarean Scar Pregnancy by Transcatheter Arterial Chemoembolization
title_full_unstemmed Abruptio Placentae in Subsequent Pregnancy after Conservative Management of Hemorrhagic Cesarean Scar Pregnancy by Transcatheter Arterial Chemoembolization
title_short Abruptio Placentae in Subsequent Pregnancy after Conservative Management of Hemorrhagic Cesarean Scar Pregnancy by Transcatheter Arterial Chemoembolization
title_sort abruptio placentae in subsequent pregnancy after conservative management of hemorrhagic cesarean scar pregnancy by transcatheter arterial chemoembolization
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747996/
https://www.ncbi.nlm.nih.gov/pubmed/23997578
http://dx.doi.org/10.4137/CCRep.S12744
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