Medical Management of Cesarean Scar Pregnancy

Abstract

Caesarean scar pregnancy (CSP) is an uncommon type of ectopic pregnancy. Here, we aim to present management of our four CSP cases. These cases were enrolled between January 2012 and January 2016. All the patients treated with 50 mg/m intramuscular methotrexate (MTX) injection. After treatment, patients were followed until their serum beta human chorionic gonadotropin (β-hCG) levels reached <5 mIU/mL. All the patients were diagnosed at the first trimester, with the average gestational age of 7 weeks. All patients were cured without surgery. The mean time passed until β-hCG reached <5 mIU/mL was 28 (range, 22-35) days. Only one patient needed second dose MTX. Based on this limited number of case-series experience, it seems that systemic MTX should be the first line treatment for CSP instead of surgery.

Keywords

• Ectopic Pregnancy
• Caesarean Scar
• Methotrexate

Sezaryen Skar Gebeliklerinde Medikal Tedavi

Abstract

Sezaryen skar gebelikleri çok nadir görülen ektopik gebelik tiplerinden biridir. Biz bu çalışmada sezaryen skar gebeliği olan 4 olguyu sunmak istedik. Bu çalışma Ocak 2012-2016 yılları arasında yapılmıştır. Tüm hastalar intramüsküler olarak 50 mg/m2 metotreksat (MTX) ile tedavi edilmişlerdir. Tedavi sonrasında hastalar serum insan koryonik gonadotropin (ß-hCG) düzeyleri <5 mIU/mL olana kadar izlenmişlerdir. Tüm hastalara ilk trimesterde, ortalama olarak 7. gebelik haftasında tanı konulmuştur. Tüm hastalar cerrahi gereksinimi olmadan iyileşmişlerdir. ß-hCG değeri <5 mIU/mL olana kadar geçen ortalama süre 28 (22-35) gündü. Sadece bir hastanın ikinci doz tedaviye gereksinimi oldu. Bu sınırlı olgu serisinden çıkan tecrübemize göre sistemik metotreksat tedavisi cerrahi tedaviden önce ilk basamak tedavi olarak uygulanabilir.

Keywords

• Gebelik
• Ektopik
• Sezaryen
• Metotreksat

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