title: Endoscopic management of cesarean scar pregnancy.
abstract: 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.
authors.affiliation: 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.
authors.forename: Chin-Jung
authors.initials: CJ
authors.lastname: Wang
authors.forename: An-Shine
authors.initials: AS
authors.lastname: Chao
authors.forename: Leung-To
authors.initials: LT
authors.lastname: Yuen
authors.forename: Chia-Wei
authors.initials: CW
authors.lastname: Wang
authors.forename: Yung-Kuei
authors.initials: YK
authors.lastname: Soong
authors.forename: Chyi-Long
authors.initials: CL
authors.lastname: Lee
mesh_terms: 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