title: Pregnancy after endometrial ablation. A report of three cases.
abstract: BACKGROUND
  Pregnancies after endometrial ablation (EA) are rare and are associated with high morbidity, especially in the second and third trimesters.
  
  
  METHODS
  We report 3 cases of pregnancy after EA in which severe complications occurred during the first trimester. The first case concerns an unexpected pregnancy after EA in a 50-year-old woman. Hysterectomy via laparotomy was needed because of heavy bleeding and severe anemia. Pathology showed a complete hydatidiform mole without invasion. Ultrasound-guided in situ methotrexate injection could be a nonsurgical alternative to terminate an intrauterine pregnancy after EA when the pregnancy is located within uterine synechiae, as shown by the second case. The third case presented as an accreta placentation mimicking hyperplastic myometrial invasion in a 46-year-old patient.
  
  
  CONCLUSIONS
  Because of the high morbidity of these pregnancies that could still occur after EA, patients need contraception after EA, and concomitant hysteroscopic sterilization should be proposed at the same time.
authors.affiliation: Department of Obstetrics and Gynecology and Reproductive Medicine, Antoine Beclere Hospital, Clamart, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Roux
authors.forename: Mausumi
authors.initials: M
authors.lastname: Das
authors.forename: Hervé
authors.initials: H
authors.lastname: Fernandez
authors.forename: Xavier
authors.initials: X
authors.lastname: Deffieux
mesh_terms: D000032:Abortion, Therapeutic; D000328:Adult; D017115:Catheter Ablation / Q000009:adverse effects; D004717:Endometrium / Q000601:surgery*; D005260:Female; D006175:Gynatresia / Q000209:etiology; D006801:Humans; D006828:Hydatidiform Mole / Q000601:surgery*; D007044:Hysterectomy; D008595:Menorrhagia / Q000601:surgery*; D008875:Middle Aged; D010921:Placenta Accreta / Q000601:surgery; D011247:Pregnancy; D014594:Uterine Neoplasms / Q000601:surgery*