title: Cesarean scar pregnancies successfully treated with methotrexate.
abstract: Three cases of cesarean scar pregnancy successfully treated with methotrexate are described. The diagnosis was confirmed by transvaginal sonographic examinations showing a well-formed gestational sac in the myometrium of the lower uterine segment. Initial treatment with a systemic injection of 50 mg of methotrexate was not sufficient, and multiple doses were required to obtain a complete remission in two cases. In a case with a beta-hCG level of more than 20,000 mIU/mL with a viable embryo in a gestational sac, a combination of systemic and local treatment with methotrexate was required. It took 7-11 weeks for the beta-hCG level to become undetectable and 12-17 weeks for the cesarean scar pregnancy mass to disappear completely.
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Muraji
authors.forename: Seiji
authors.initials: S
authors.lastname: Mabuchi
authors.forename: Koji
authors.initials: K
authors.lastname: Hisamoto
authors.forename: Mariko
authors.initials: M
authors.lastname: Muranishi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kanagawa
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Nishio
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura