Cesarean scar ectopic pregnancy, a life threatening condition: a case report

Abstract

Cesarean scar ectopic pregnancy, a life threatening condition: a case report M. Meléndez Zalduegui 1 , S. Iglesias Ferreiro 1 , A. Rodríguez Vélez 1 , ML. Monje Beltrán 1 , EM. Vicedo Madrazo 1 , RJ. Martínez Portillo 2 , M. Llobet Roma 3 , M. Marqueta Sánchez 1 1Department of Gynecology and Obstetrics, Hospital de Palamós, Girona; 2Hospital Clinic, Barcelona 3Department of Pathology, Hospital de Palamós, Girona (Spain) Summary A cesarean scar ectopic pregnancy (CSEP) is a rare and life-threatening condition with a prevalence of one over 3,000 pregnancies. If not promptly diagnosed, patients may undergo fatal results. There is no consensus for the management of this type of ectopic pregnancy. The authors present a series of three cases involving different clinical scenarios for the management of cesarean ectopic pregnancy. The diagnosis was made using laboratory results, ultrasound images, and surgery. Treatment was performed using different techniques according to this hospital’s capabilities; from surgery to methotrexate use, all with satisfactory results. The authors discuss the clinical significance and differential diagnosis of CSEP in the setting of a second level reference hospital. Key words: Cesarean scar; Ectopic pregnancy; Methotrexate; Hysterectomy; Cesarean scar ectopic pregnancy.