Arıkan, Deniz Cemgil Sütçü Imam University - School of Medicine - Department of Obstetrics and Gynecology, Turkey , Turgut, Emre Istanbul Education and Research Hospital - Department of Obstetrics and Gynecology, Turkey , Kıran, Gürkan Sütçü Imam University - School of Medicine - Department of Obstetrics and Gynecology, Turkey , Kıran, Hakan Sütçü Imam University - School of Medicine - Department of Obstetrics and Gynecology, Turkey

Cesarean scar pregnancy treated with methotrexate and dilatation-currettage: Case report

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Cesarean scar pregnancy (CSP) is the rarest form of ectopic pregnancies that can cause serious complications. A 37 year-old woman with past history of gravida 4, parity 2, cesarian section, admitted to our outpatient clinic with the complaint of mild pelvic pain and 6 weeks 2 day of amenorrhea. On admission, her serum β-human chorionic gonadotropin (β-hCG) level was 26905 mIU/mL and transvaginal ultrasound revealed a 24 mm gestational sac implanted at the site of her prior cesarean section scar. Initial treatment with single-dose systemic methotrexate (MTX) (1mg/kg; 60 mg) was not sufficient so the dose of MTX (60 mg) was repeated. In the follow-up the gestational sac continued to increase in size and patient started to feel abdominal discomfort, so we performed an ultrasound-guided dilatation and curettage to obtain complete remission. MTX treatment alone or in conjunction with dilatation-curettage may avoid unnecessary laparotomy, hysterectomy and preserve fertility CSP patients.

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Cesarean scar pregnancy , methotrexate , dilatation and curettage

Dicle Medical Journal

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