Treatment of Scar Pregnancy by a Combined Medical and Non-Invasive Surgical Approach: A Case Report and Literature Review
Cesarean scar pregnancy" (CSP) is one of the rarest types of ectopic pregnancy with an estimated prevalence of 1 in 1500/2000 women with previous caesarean sections. Risk of developing CSP depends mostly from number of previous cesarean section. Until now two kinds of CSP have been described depending on the progressive expansion of the lesion towards the uterine wall: development towards the uterine cavity or cervico-isthmic region (Type I) or exogenous invasion towards the bladder and the abdominal cavity (Type II). Symptoms of CSP are not specific and diagnosis is usually made by pelvic-transvaginal ultrasound in the first gestational weeks. Early diagnosis of CSP is very important to be able to choose the best therapeutic approach in order to minimize risk of patient complications. However, currently there is no standard management as few cases have been reported in literature. Available treatment options include medical or surgical approaches or a combination of both and should be tailored on patients’ and lesions’ characteristics. Here we report our experience with the case of an African young woman affected by Type I scar pregnancy diagnosed at 9 weeks of gestation and successfully treated with intra-lesional methotrexate infusion followed by non-invasive approach.
Tibaldi V, Musella A*, Bracchi C, Santangelo G, D’Aniello D, Palaia I, Di Donato V, Giannini A, Pastore G, Colagiovanni V, Benedetti PP and Monti M
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