title: Management of a case of caesarean scar pregnancy and all its complications.
abstract: Caesarean scar pregnancy is a rare form of an ectopic pregnancy that can lead to serious consequences like massive bleeding and uterine rupture. Although there is no consensus for treatment, many treatment options have been described. We present a female patient who had to undergo most of these available treatments due to unforeseen circumstances. These treatments include local injection of methotrexate and potassium chloride into the pregnancy, transcervical aspiration of the pregnancy under laparoscopic guidance, balloon occlusion of the internal iliac arteries and eventually a laparoscopic hysterectomy. She also developed a complication of vault dehiscence due to an abscess formation after her hysterectomy. Owing to the potential need for multiple interventions and admissions, adequate counselling is required for these patients to manage their expectations in what is usually a very difficult situation.
authors.affiliation: Department of Reproductive Medicine, KK Womens' and Childrens' Hospital, Singapore, Singapore.
authors.forename: Shuling
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Obstetrics & Gynaecology, Singhealth, Singapore, Singapore.
authors.forename: Shivani
authors.initials: S
authors.lastname: Durai
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D021721:Balloon Occlusion / Q000379:methods; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D010535:Laparoscopy / Q000379:methods; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D011189:Potassium Chloride / Q000008:administration & dosage / Q000627:therapeutic use; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000209:etiology* / Q000628:therapy*
chemical_list: D000900:Anti-Bacterial Agents; D011189:Potassium Chloride; D008727:Methotrexate