Therapeutic options of caesarean scar pregnancy: case series and literature review.
We describe our experience with the treatment of 4 caesarean scar pregnancies and provide an overview of current literature. Four women diagnosed with a caesarean scar pregnancy in our hospital between 1996 and 2007 were treated with local or systemic methotrexate and had a steady decline of the serum beta-hCG level. The uterus was preserved in all women and 3 of them had an uneventful subsequent pregnancy and delivery. We suggest that transcervical needle aspiration of amniotic fluid followed by intra-amniotic injection of methotrexate should be the treatment of choice, followed by surgical treatment only if methotrexate fails.
de Vaate
A J Marjolein Bij
AJ
Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands.
Brölmann
Hans A M
HA
van der Slikke
Johannes W
JW
Wouters
Maurice G A J
MG
Schats
Roel
R
Huirne
Judith A F
JA
D000328:Adult; D000650:Amnion; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000150:complications* / Q000000981:diagnostic imaging; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D007813:Laparotomy / Q000379:methods*; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D009215:Myometrium; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*
D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate