title: Intact removal of spontaneous twin ectopic Caesarean scar pregnancy by office hysteroscopy: case report and literature review.
abstract: Caesarean scar pregnancy is a dangerous condition that occurs when an embryo is implanted in a previous Caesarean scar. This condition has become more frequent as a direct consequence of the increased number of Caesarean sections reported worldwide. Timely diagnosis of this condition is fundamental, and allows a conservative approach to preserving fertility. A wide range of medical and surgical strategies has been described, with no consensus on preferred management. Recently, hysteroscopic surgery has been proposed as a conservative strategy, with interesting results in reproductive outcome, postoperative course and success rate. Most cases of Caesarean scar pregnancy reported worldwide involve a singleton pregnancy. A peculiar case of fully documented office hysteroscopic removal of twin Caesarean scar pregnancy is presented in this paper. This procedure took place in a tertiary care university hospital without cervix dilatation, under conscious sedation, after failure of systemic methotrexate administration. Complete removal of the ectopic pregnancy was obtained without intra- and postoperative complications.
authors.affiliation: Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche -Università degli Studi di Napoli 'Federico II', Via Sergio Pansini, 5-80131, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Mollo
authors.affiliation: Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche -Università degli Studi di Napoli 'Federico II', Via Sergio Pansini, 5-80131, Naples, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Alviggi
authors.affiliation: Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche -Università degli Studi di Napoli 'Federico II', Via Sergio Pansini, 5-80131, Naples, Italy. Electronic address: confale@hotmail.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Conforti
authors.affiliation: Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli 'Federico II', Via Sergio Pansini, 5-80131, Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Insabato
authors.affiliation: Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche -Università degli Studi di Napoli 'Federico II', Via Sergio Pansini, 5-80131, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Placido
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000503:physiopathology*; D016292:Procedural Sedation; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D008727:Methotrexate / Q000627:therapeutic use; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000601:surgery*; D059285:Pregnancy, Twin; D016896:Treatment Outcome
chemical_list: D008727:Methotrexate
keywords: caesarean scar pregnancy; ectopic pregnancy; hysteroscopy; twin pregnancy