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Hysteroscopy and suction evacuation of cesarean scar pregnancies: A case report and review
Author(s) -
Fylstra Donald L.
Publication year - 2014
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12260
Subject(s) - medicine , hysteroscopy , pregnancy , ectopic pregnancy , obstetrics , cesarean delivery , curettage , gestational sac , uterine rupture , suction , hysterectomy , surgery , gynecology , uterus , genetics , mechanical engineering , engineering , biology
Implantation of a pregnancy into the scar of a prior cesarean is an uncommon type of ectopic pregnancy. The incidence of cesarean scar pregnancy is thought to be one in 1800–2216 pregnancies. The increase in the incidence of cesarean scar pregnancy is thought to be a consequence of the increasing rates of cesarean delivery. The natural history of cesarean scar pregnancy is unknown. However, if such a pregnancy is allowed to continue, uterine scar rupture with hemorrhage and possible hysterectomy seem likely. Two early diagnosed cesarean scar pregnancies were treated with hysteroscopy and suction curettage removal. One required intramuscular methotrexate to resolve a persistent cesarean scar ectopic pregnancy. It would seem reasonable that simple suction evacuation would frequently leave chorionic villi imbedded within the cesarean scar, as the pregnancy is not within the endometrial cavity.