IJMDC. 2021; 5(5): 1257-1259

Successful management of an ectopic cesarean scar pregnancy: a case report

Authors: Laila Rafie, Razan Anwr Kurdi, Ebrahim Alebrahim.

ABSTRACT

Background: Early diagnosis and emergency management is essential to avoid significant bleeding, uterine rupture, and increased risk of maternal mortality in the ectopic cesarean scar pregnancy (CSP). Case presentation: A 33-year old Saudi patient G7 P4 + 2 was presented to emergency department with vaginal bleeding for 1 day at 8th week of pregnancy. The patient had a history of four cesarean deliveries. Her most recent pregnancy was 4 years prior to her presentation. Pelvic examination showed closed cervix. Laboratory investigations were normal. Beta human chorionic gonadotropin (β-hCG) was 103,517 mIU/ml at presentation. Ultrasound showed that gestational sac (GS) was low in position at level of caesarean section (CS) scar and fetal heart sound (FH) was positive. The diagnosis of ectopic CS scar pregnancy was done. Methotrexate 100 mg intramuscular (IM) was started. On 2nd day, β-hCG raised to 121,531 mIU/ml. The patient received the second dose on 4th day. β-hCG raised to 125,385 mIU/ml. Ultrasound showed the area of separation of the GS and FH+. After 1 week, the patient received the third dose of methotrexate local embryocidal injection. By next day, β-hCG dropped to 83,633 mIU/ml. Ultrasound showed FH-. On the 9th day, the patient was completely well and β-hCG dropped to 826 mIU/ml. Conclusion: Clinicians should be aware of the diagnosis and management of CSP. CSP remains rare but might lead to severe uncontrolled bleeding, increase risk of maternal mortality, and future infertility. Early diagnosis and treatment are important for the best outcome.

Keywords:
Cesarean scar pregnancy, ectopic pregnancy, case report, methotrexate, suction evacuation.


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Successful management of an ectopic cesarean scar pregnancy: a case report


Authors
Laila Rafie
MBBS, Saudi board, Consultant of Obstetrics and Gynecology, Madinah Maternity and Children Hospital, Madinah, Saudi Arabia
PubMed articlesGoogle scholar articles

Razan Anwr Kurdi
MBBS, Resident of Obstetrics and Gynecology, East Jeddah General Hospital. Batterjee Medical College, Jeddah, Saudi Arabia
PubMed articlesGoogle scholar articles

Ebrahim Alebrahim
Medical student, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
PubMed articlesGoogle scholar articles


Correspondence to:
. Ebrahim Alebrahim, Medical student, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.; E.alebrahim97@gmail.com

Publication history
Received 04 Mar 2021
Accepted 19 Mar 2021
Published online 23 May 2021
Published in print 06 Jun 2021

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Pubmed Style

Rafie L, Kurdi RA, Alebrahim E. Successful management of an ectopic cesarean scar pregnancy: a case report. IJMDC. 2021; 5(5): 1257-1259. doi:10.24911/IJMDC.51-1604857156


Web Style

Rafie L, Kurdi RA, Alebrahim E. Successful management of an ectopic cesarean scar pregnancy: a case report. https://www.ijmdc.com/?mno=27937 [Access: July 25, 2021]. doi:10.24911/IJMDC.51-1604857156


AMA (American Medical Association) Style

Rafie L, Kurdi RA, Alebrahim E. Successful management of an ectopic cesarean scar pregnancy: a case report. IJMDC. 2021; 5(5): 1257-1259. doi:10.24911/IJMDC.51-1604857156


Vancouver/ICMJE Style

Rafie L, Kurdi RA, Alebrahim E. Successful management of an ectopic cesarean scar pregnancy: a case report. IJMDC. (2021), [cited July 25, 2021]; 5(5): 1257-1259. doi:10.24911/IJMDC.51-1604857156


Harvard Style

Rafie, L., Kurdi, . R. A. & Alebrahim, . E. (2021) Successful management of an ectopic cesarean scar pregnancy: a case report. IJMDC, 5 (5), 1257-1259. doi:10.24911/IJMDC.51-1604857156


Turabian Style

Rafie, Laila, Razan Anwr Kurdi, and Ebrahim Alebrahim. 2021. Successful management of an ectopic cesarean scar pregnancy: a case report. International Journal of Medicine in Developing Countries, 5 (5), 1257-1259. doi:10.24911/IJMDC.51-1604857156


Chicago Style

Rafie, Laila, Razan Anwr Kurdi, and Ebrahim Alebrahim. "Successful management of an ectopic cesarean scar pregnancy: a case report." International Journal of Medicine in Developing Countries 5 (2021), 1257-1259. doi:10.24911/IJMDC.51-1604857156


MLA (The Modern Language Association) Style

Rafie, Laila, Razan Anwr Kurdi, and Ebrahim Alebrahim. "Successful management of an ectopic cesarean scar pregnancy: a case report." International Journal of Medicine in Developing Countries 5.5 (2021), 1257-1259. Print. doi:10.24911/IJMDC.51-1604857156


APA (American Psychological Association) Style

Rafie, L., Kurdi, . R. A. & Alebrahim, . E. (2021) Successful management of an ectopic cesarean scar pregnancy: a case report. International Journal of Medicine in Developing Countries, 5 (5), 1257-1259. doi:10.24911/IJMDC.51-1604857156


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