Sezaryen Skar Gebeliğinde İntraamniyotik Metotreksat Tedavisi Olgu Sunumu

Öz

Sezaryen skar gebelik insidansı, sezaryen artışına bağlı yükselmekte, konu ile ilgili dünya ve ülkemizde artan bilgi birikimi, skar gebeliklerde tanı, yönetim ve sonuçlar ile ilgili yayınlarla ortaya konulmaktadır. Sezaryen sonrası gebelikler, gebelik kesesinin skara yakınlığına göre: düşükler, morbidite yaratan plasenta adezyon anomalileri plasenta akreta-inkreta, perkreta uterus rüptürü, dissemine intravaskular koagulasyon ve anne ölümleri gibi komplikasyonlarla karşımıza çıkabilmektedir. Nadir görülmesi nedeniyle sezaryen skar gebeliğine dair veriler çoğunlukla olgu sunumlarına dayanır. Bu nedenle tanı ve tedavisi üzerinde fikir birliğine varılmış bir klinik yönetimi bulunmamaktadır. Biz bu çalışmamızda önce gerekli kürü sağlayamayan lokal olarak metotreksat enjeksiyonu tedavisi sonrası sedasyon altında ultrasonografi eşliğinde aspirasyon dilatasyon ve küretaj işlemi ile tedavi olmuş sezaryen yeri skar gebeliğini işleyeceğiz

Anahtar Kelimeler

• Sezaryen skar gebelik, Metotreksat, İntra-amniyotik

A Case Report of Intra-Amniotic Methotrexate Treatment in Cesarean Scar Pregnancy

Abstract

The incidence of cesarean section scar pregnancy has increased due to the increase in cesarean, the accumulation of knowledge in the world and our country, and publications on the diagnosis, management and results in scar pregnancies. Pregnancy after cesarean can be complicated by complications such as abortions, miscarriage placenta adhesion anomalies placenta acreta-increta, percreta , uterus rupture, disseminated intravascular coagulation and maternal deaths according to scar proximity. Because of its rarity, cesarean scar pregnancy is mostly based on case reports. There is therefore no clinical management consensus on the diagnosis and treatment. In this study, we will discuss cesarean section scar pregnancy treated with the aspiration dilatation and curettage procedure guided by ultrasonography under sedation after topical methotrexate injection therapy, following initial unsuccessful management

Keywords

• Cesarean scar pregnancy, Methotrexate, Intra-amniotic

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