Endoscopic management of cesarean scar pregnancy.
OBJECTIVE
To describe our experiences with the diagnosis and endoscopic treatment of cesarean scar pregnancy.


METHODS
Prospective clinical study.


METHODS
Tertiary care university hospital.


METHODS
Eleven women treated in our division between 1999 and 2004 who had been diagnosed with cesarean scar pregnancy.


METHODS
Transvaginal ultrasound was used for diagnosis, and endoscopy (laparoscopy and/or hysteroscopy) was used to treat cesarean scar pregnancy and preserve fertility.


METHODS
Operative blood loss, hospital stay, and time to resolution of serum beta-hCG were recorded.


RESULTS
The gestational age at diagnosis ranged between 6 and 11 weeks. Laparoscopic treatment was used in four women, hysteroscopic treatment in six women, and one woman underwent combined treatment with laparoscopy and hysteroscopy. The average blood loss during surgery was 110.9 mL (range, 20-300 mL), and average hospital stay was 1.7 days (range, 0.25-3 days). No complications occurred, and no blood transfusion was required. All patients' uteri were successfully preserved, and serum beta-hCG levels declined to a normal limit within 4 weeks postoperatively.


CONCLUSIONS
When the diagnosis of cesarean scar pregnancy is made in the first trimester, endoscopy can be an alternative surgical treatment; the prognosis is good, and fertility can be preserved.
Wang
Chin-Jung
CJ
Division of Gynecologic Endoscopy, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
Chao
An-Shine
AS
Yuen
Leung-To
LT
Wang
Chia-Wei
CW
Soong
Yung-Kuei
YK
Lee
Chyi-Long
CL
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000150:complications*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D010535:Laparoscopy; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography