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An Unusual Case of Live Caesarean Scar Ectopic Pregnancy: A Common Entity in an Uncommon Location

BACKGROUND: Scar pregnancy is an extremely rare type of ectopic pregnancy, where there is implantation of the gestational sac onto the anterior wall of the uterus at the site of previous LSCS scar in a multipara female. Due to a poor vascular supply to the lower uterine segment, caesarean scars may...

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Detalles Bibliográficos
Autores principales: Joshi, Sayali D., Momin, Shenaz A., Shetty, Dev
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466375/
https://www.ncbi.nlm.nih.gov/pubmed/28638494
http://dx.doi.org/10.12659/PJR.901118
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author Joshi, Sayali D.
Momin, Shenaz A.
Shetty, Dev
author_facet Joshi, Sayali D.
Momin, Shenaz A.
Shetty, Dev
author_sort Joshi, Sayali D.
collection PubMed
description BACKGROUND: Scar pregnancy is an extremely rare type of ectopic pregnancy, where there is implantation of the gestational sac onto the anterior wall of the uterus at the site of previous LSCS scar in a multipara female. Due to a poor vascular supply to the lower uterine segment, caesarean scars may heal improperly predisposing it to be a site of improper implantation of the gestational sac. RESULTS: The characteristic features are empty uterus and cervix, gestational sac in the anterior part of lower uterine segment with a history of painless vaginal bleeding. It carries a high risk of morbidity related to uterine rupture and extensive haemorrhage. CONCLUSIONS: In case of a previous LSCS delivery in a female with a viable gestational sac in the lower uterine segment and elevated B-Hcg levels, the possibility of scar ectopic pregnancy should be considered. KCl or methotrexate can be injected directly into the foetal pole under transvaginal ultrasound guidance in order to stop the cardiac activity in the foetus. The knowledge of the specific ultrasound features of uncommon locations of ectopic pregnancies such as an ectopic scar is crucial for a correct diagnosis and early management in order to prevent complications.
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spelling pubmed-54663752017-06-21 An Unusual Case of Live Caesarean Scar Ectopic Pregnancy: A Common Entity in an Uncommon Location Joshi, Sayali D. Momin, Shenaz A. Shetty, Dev Pol J Radiol Case Report BACKGROUND: Scar pregnancy is an extremely rare type of ectopic pregnancy, where there is implantation of the gestational sac onto the anterior wall of the uterus at the site of previous LSCS scar in a multipara female. Due to a poor vascular supply to the lower uterine segment, caesarean scars may heal improperly predisposing it to be a site of improper implantation of the gestational sac. RESULTS: The characteristic features are empty uterus and cervix, gestational sac in the anterior part of lower uterine segment with a history of painless vaginal bleeding. It carries a high risk of morbidity related to uterine rupture and extensive haemorrhage. CONCLUSIONS: In case of a previous LSCS delivery in a female with a viable gestational sac in the lower uterine segment and elevated B-Hcg levels, the possibility of scar ectopic pregnancy should be considered. KCl or methotrexate can be injected directly into the foetal pole under transvaginal ultrasound guidance in order to stop the cardiac activity in the foetus. The knowledge of the specific ultrasound features of uncommon locations of ectopic pregnancies such as an ectopic scar is crucial for a correct diagnosis and early management in order to prevent complications. International Scientific Literature, Inc. 2017-06-01 /pmc/articles/PMC5466375/ /pubmed/28638494 http://dx.doi.org/10.12659/PJR.901118 Text en © Pol J Radiol, 2017 This is an open access article. Unrestricted non-commercial use is permitted provided the original work is properly cited.
spellingShingle Case Report
Joshi, Sayali D.
Momin, Shenaz A.
Shetty, Dev
An Unusual Case of Live Caesarean Scar Ectopic Pregnancy: A Common Entity in an Uncommon Location
title An Unusual Case of Live Caesarean Scar Ectopic Pregnancy: A Common Entity in an Uncommon Location
title_full An Unusual Case of Live Caesarean Scar Ectopic Pregnancy: A Common Entity in an Uncommon Location
title_fullStr An Unusual Case of Live Caesarean Scar Ectopic Pregnancy: A Common Entity in an Uncommon Location
title_full_unstemmed An Unusual Case of Live Caesarean Scar Ectopic Pregnancy: A Common Entity in an Uncommon Location
title_short An Unusual Case of Live Caesarean Scar Ectopic Pregnancy: A Common Entity in an Uncommon Location
title_sort unusual case of live caesarean scar ectopic pregnancy: a common entity in an uncommon location
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466375/
https://www.ncbi.nlm.nih.gov/pubmed/28638494
http://dx.doi.org/10.12659/PJR.901118
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