Successful term pregnancy after treatment of a cesarean scar ectopic gestation by endoscopic technique and conservative therapy.
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.
Korkontzelos
Ioannis
I
Department of Obstetrics and Gynecology, Ioannina State General Hospital G Chatzikosta, Ioannina, Greece. i.korkontzelos@yahoo.com
Tsirkas
Panagiotis
P
Antoniou
Nikolaos
N
Souliotis
Dimitrios
D
Kosmas
Ioannis
I
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
D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate