title: Successful term pregnancy after treatment of a cesarean scar ectopic gestation by endoscopic technique and conservative therapy.
abstract: OBJECTIVE
  To describe a case of cesarean scar pregnancy treated successfully by endoscopic technique and medical therapy.
  
  
  METHODS
  Case report.
  
  
  METHODS
  State general hospital in a major city.
  
  
  METHODS
  A 32-year-old woman with two cesarean sections and a recent curettage presented with ectopic cesarean scar pregnancy.
  
  
  METHODS
  Transvaginal ultrasound and hysteroscopy were used for diagnosis, and conservative therapy with methotrexate and hysteroscopy to treat the patient.
  
  
  METHODS
  Modified hysteroscopic technique and outcome.
  
  
  RESULTS
  Sonography and hysteroscopy revealed the presence of a gestational sac in the lower segment of the uterus in a patient with a cesarean section scar. She was successfully treated with systemic methotrexate and aspiration of the sac and local methotrexate injection under endoscopic control.
  
  
  CONCLUSIONS
  Endoscopic intervention combined with medical treatment can result in a good therapeutic outcome with preservation of fertility in early ectopic cesarean scar pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, Ioannina State General Hospital G Chatzikosta, Ioannina, Greece. i.korkontzelos@yahoo.com
authors.forename: Ioannis
authors.initials: I
authors.lastname: Korkontzelos
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Tsirkas
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Antoniou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Souliotis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kosmas
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000209:etiology*; D005260:Female; D005298:Fertility; D005865:Gestational Age; D006801:Humans; D015907:Hysteroscopy; D007231:Infant, Newborn; D050498:Live Birth; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging / Q000628:therapy*; D016216:Ultrasonography, Prenatal
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate