Three-dimensional power Doppler ultrasound diagnosis and laparoscopic management of a pregancy in a previous cesarean scar.
An ectopic pregnancy developing in a previous Cesarean section scar is a rare event, and there is still a lack of information concerning the adequacy of management strategies. So far, no modality can guarantee the integrity of the uterus. We report the case of a 29-year-old woman with three Cesarean deliveries who was transferred to our hospital with a diagnosis of cervical pregnancy. Transvaginal three-dimensional power Doppler ultrasound revealed a well-encapsulated bulging mass displacing anteriorly over the lower anterior uterine wall sounding with an irregular course and branching vessels. The diagnosis of pregnancy in a previous Cesarean scar was made. Laparoscopic ligation of bilateral uterine arteries followed by excision of the ectopic pregnant mass was undertaken, and the patient's uterus was successfully preserved. Conservative management with the laparoscopic approach may be a safe and effective alternative to hysterectomy in patients with a pregnacy in a previous Cesarean scar.
Wang
Chin-Jung
CJ
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Kwei-Shan Tao-Yuan, Taiwan.
Yuen
Leung-To
LT
Yen
Chih-Feng
CF
Lee
Chyi-Long
CL
Soong
Yung-Kuei
YK
D000328:Adult; D002585:Cesarean Section; D002921:Cicatrix; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging* / Q000601:surgery; D018608:Ultrasonography, Doppler