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Ectopic Pregnancy located at the Cesarean Scar

Yıl 2019, Cilt: 28 Sayı: 1, 28 - 40, 31.03.2019

Öz

The aim of our study is to review previous studies in literature on caesarean scar ectopic pregnancy since 1978; the year the first case was reported until March 2017, and to compare the current diagnostic and treatment methods used in management of caesarean scar ectopic pregnancy. Measurement of serum human chorionic gonadotropin levels, ultrasonography, doppler ultrasonography and sometimes magnetic resonance imaging are used for differential diagnosis of caesarean scar ectopic pregnancy. The most common treatment methods are; dilatation and curettage, local or systemic methotrexate application, selective uterine artery embolization and hysterotomy. 

Kaynakça

  • 1- NICE guidelines [CG154]. Ectopic pregnancy and miskarriage: diagnosis and initial management in early pregnancy of ectopic pregnancy and miscarriage. 2012, https://www. ncbi.nlm.nih.gov/ pubmed/23638497
  • 2- Clark EAS, Silver RM. Long-term maternal morbidity associated with repeat cesarean delivery. AJOG 2011;205(6 Suppl.):S2e10)
  • 3- Larsen JV, Solomon MH. Pregnancy in a uterine scar sacculus an unusual cause of postabortal haemorrhage. A case report. S Afr Med J. 1978 28;53(4):142-3.
  • 4- Richardson A, Gallos I, Dobson S, Campbell BK, Coomarasamy A, Raine-Fenning N. Accuracy of first-trimester ultrasound in diagnosis of tubal ectopic pregnancy in the absence of an obvious extrauterine embryo: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2016;47(1):28–37
  • 5- Timor-Tritsch IE, Monteagudo A, Santos R, Tsymbal T, Pineda G, Arslan AA. The diagnosis, treatment, and follow-up of cesarean scar pregnancy. AJOG 2012; 207:44.e1e44.e13.
  • 6- Litwicka K, Greco E. Caesarean scar pregnancy: a review of management options. Curr Opin Obstet Gynecol 2013;25:456e61.
  • 7- Fylstra DL. Ectopic pregnancy within a cesarean scar: a review. Obstet Gynecol Surv 2002;57:537–43.
  • 8- Godin P-A, Bassil S, Donnez J. An ectopic pregnancy developing in a previous caesarean section scar. Fertil Steril 1997;67:398–400
  • 9- Maymon R, Halperin R, Mendlovic S, Schneider D, Herman A. Ectopic pregnancies in a caesarean scar: review of the medical approach to an iatrogenic complication. Hum Reprod Update 2004;10:515–23
  • 10- Zhang Y, Gu Y, Wang JM, Li Y. Analysis of cases with cesarean scar pregnancy. J Obstet Gynaecol Res 2013; 39:195–202.
  • 11- Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management. Obstet Gynecol. 2006; 107:1373–1381.
  • 12- Kung FT, Huang TL, Chen CW, Cheng YF. Image in reproductive medicine. Cesarean scar ectopic pregnancy. Fertil Steril. 2006; 85:1508–1509.
  • 13- Shih JC. Cesarean scar pregnancy: diagnosis with three-dimensional (3D) ultrasound and 3D power Doppler. Ultrasound Obstet Gynecol 2004; 23:306–7.
  • 14- Roberts H, Kohlenber C, Lanzarone V, Murray H. Ectopic pregnancy in lower segment uterine scar. Aust N Z J ObstetGynaecol 1998; 38:114–16.
  • 15- Maymon R, Halperin R, Mendlovic S, Schneider D, Vaknin Z, Herman A, et al. Ectopic pregnancies in Caesarean scars: the 8 year experience of one medical centre. Hum Reprod 2004; 19:278–84.
  • 16- Caserta NMG, Bacha AM, Grassiotto OR. Cesarean scar ectopic pregnancy: invasion of the bladder wall detected by magnetic resonance imaging. Radiol Bras. 2017; 50(3):197-198
  • 17- Huang Q, Zhang M, Zhai RY. The use of contrast-enhanced magnetic resonance imaging to diagnose cesarean scar pregnancies. Int J Gynaecol Obstet. 2014;127:144–146.
  • 18- Caserta NMG, Bacha AM, Grassiotto OR. Cesarean scar ectopic pregnancy: invasion of the bladder wall detected by magnetic resonance imaging. Radiol Bras. 2017; 50(3): 197–198.
  • 19- Jiang S, Sheng X, Li Q. Endoscopy Surgery for Ectopic Pregnancy Within Cesarean Scar. J Minim Invasive Gynecol. 2015; 22(6S):S80-S81.
  • 20- Michaels AY, Washburn EE, Pocius KD, Benson CB, Doubilet PM, Carusi DA. Outcome of cesarean scar pregnancies diagnosed sonographically in the first trimester. J Ultrasound Med 2015; 34:595–9.
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  • 22- Yang Q, Piao S, Wang G, Wang Y, Liu C. Hysteroscopic surgery of ectopic pregnancy in the cesarean section scar. J Minim Invasive Gynecol 2009; 16:432–6.
  • 23- Wang CJ, Yuen LT, Chao AS, Lee CL, Yen CF, Soong YK. Caesarean scar pregnancy successfully treated by operative hysteroscopy and suction curettage. BJOG 2005; 112:839e40
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  • 73- Zhang B, Jiang ZB, Huang MS, Guan SH, Zhu KS, Qian JS, et al. Uterine artery embolization combined with methotrexate in the treatment of cesarean scar pregnancy: results of a case series and review of the literature. J Vasc Interv Radiol 2012; 23:1582–8.
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  • 82- Le A, Shan L, Xiao T, Zhuo R, Xiong H, Wang Z. Transvaginal surgical treatment of cesarean scar ectopic pregnancy. Arch Gynecol Obstet 2013; 287: 791–6.
  • 83- Xiao J, Zhang S, Wang F, Wang Y, Shi Z, Zhou X, et al. Cesarean scar pregnancy: noninvasive and effective treatment with high-intensity focused ultrasound. Am J Obstet Gynecol 2014; 211:356.e1–7.
  • 84- Timor-Tritsch IE, Monteagudo A, Santos R, Tsymbal T, Pineda G, Arslan AA. The diagnosis, treatment, and follow-up of cesarean scar pregnancy. Am J Obstet Gynecol 2012; 207:44.e1–13.
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Sezaryen Skar Yeri Ektopik Gebeliği

Yıl 2019, Cilt: 28 Sayı: 1, 28 - 40, 31.03.2019

Öz

Çalışmamızın amacı sezaryen skar ektopik gebeliğinin ilk olgu sunumu olarak yayınlandığı 1978 ile Mart 2017 tarihleri arasında literatürde yer almış çalışmaları gözden geçirmek ve, sezaryen skar ektopik gebeliğinin yönetiminde kullanılan güncel tanı ve tedavi yöntemlerinikarşılaştırmaktır. Sezaryen skar ektopik gebeliğinin ayırıcı tanısında serum human chorionic gonadotropin düzeyi saptanması, ultrasonografi, doppler ultrasonografi ve bazı durumlarda da manyetik rezonans görüntüleme kullanılmaktadır. Standart bir tedavi yöntemi tanımlanmamakla birlikte en sık olarak dilatasyon ve küretaj, lokal veya sistemik metotreksat uygulanması, selektif uterin arter embolizasyonu ve histerotomi uygulanmaktadır.

Kaynakça

  • 1- NICE guidelines [CG154]. Ectopic pregnancy and miskarriage: diagnosis and initial management in early pregnancy of ectopic pregnancy and miscarriage. 2012, https://www. ncbi.nlm.nih.gov/ pubmed/23638497
  • 2- Clark EAS, Silver RM. Long-term maternal morbidity associated with repeat cesarean delivery. AJOG 2011;205(6 Suppl.):S2e10)
  • 3- Larsen JV, Solomon MH. Pregnancy in a uterine scar sacculus an unusual cause of postabortal haemorrhage. A case report. S Afr Med J. 1978 28;53(4):142-3.
  • 4- Richardson A, Gallos I, Dobson S, Campbell BK, Coomarasamy A, Raine-Fenning N. Accuracy of first-trimester ultrasound in diagnosis of tubal ectopic pregnancy in the absence of an obvious extrauterine embryo: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2016;47(1):28–37
  • 5- Timor-Tritsch IE, Monteagudo A, Santos R, Tsymbal T, Pineda G, Arslan AA. The diagnosis, treatment, and follow-up of cesarean scar pregnancy. AJOG 2012; 207:44.e1e44.e13.
  • 6- Litwicka K, Greco E. Caesarean scar pregnancy: a review of management options. Curr Opin Obstet Gynecol 2013;25:456e61.
  • 7- Fylstra DL. Ectopic pregnancy within a cesarean scar: a review. Obstet Gynecol Surv 2002;57:537–43.
  • 8- Godin P-A, Bassil S, Donnez J. An ectopic pregnancy developing in a previous caesarean section scar. Fertil Steril 1997;67:398–400
  • 9- Maymon R, Halperin R, Mendlovic S, Schneider D, Herman A. Ectopic pregnancies in a caesarean scar: review of the medical approach to an iatrogenic complication. Hum Reprod Update 2004;10:515–23
  • 10- Zhang Y, Gu Y, Wang JM, Li Y. Analysis of cases with cesarean scar pregnancy. J Obstet Gynaecol Res 2013; 39:195–202.
  • 11- Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management. Obstet Gynecol. 2006; 107:1373–1381.
  • 12- Kung FT, Huang TL, Chen CW, Cheng YF. Image in reproductive medicine. Cesarean scar ectopic pregnancy. Fertil Steril. 2006; 85:1508–1509.
  • 13- Shih JC. Cesarean scar pregnancy: diagnosis with three-dimensional (3D) ultrasound and 3D power Doppler. Ultrasound Obstet Gynecol 2004; 23:306–7.
  • 14- Roberts H, Kohlenber C, Lanzarone V, Murray H. Ectopic pregnancy in lower segment uterine scar. Aust N Z J ObstetGynaecol 1998; 38:114–16.
  • 15- Maymon R, Halperin R, Mendlovic S, Schneider D, Vaknin Z, Herman A, et al. Ectopic pregnancies in Caesarean scars: the 8 year experience of one medical centre. Hum Reprod 2004; 19:278–84.
  • 16- Caserta NMG, Bacha AM, Grassiotto OR. Cesarean scar ectopic pregnancy: invasion of the bladder wall detected by magnetic resonance imaging. Radiol Bras. 2017; 50(3):197-198
  • 17- Huang Q, Zhang M, Zhai RY. The use of contrast-enhanced magnetic resonance imaging to diagnose cesarean scar pregnancies. Int J Gynaecol Obstet. 2014;127:144–146.
  • 18- Caserta NMG, Bacha AM, Grassiotto OR. Cesarean scar ectopic pregnancy: invasion of the bladder wall detected by magnetic resonance imaging. Radiol Bras. 2017; 50(3): 197–198.
  • 19- Jiang S, Sheng X, Li Q. Endoscopy Surgery for Ectopic Pregnancy Within Cesarean Scar. J Minim Invasive Gynecol. 2015; 22(6S):S80-S81.
  • 20- Michaels AY, Washburn EE, Pocius KD, Benson CB, Doubilet PM, Carusi DA. Outcome of cesarean scar pregnancies diagnosed sonographically in the first trimester. J Ultrasound Med 2015; 34:595–9.
  • 21- Pavlova E, Gunev D, Diavolov V, Slavchev B. Cesarean scar ectopic pregnancy: diagnosis with 2D, three-dimensional (3D) ultrasound and 3D power doppler of a case and review of the literatüre. Akush Ginekol (Sofia). 2013; 52(6):43-52.
  • 22- Yang Q, Piao S, Wang G, Wang Y, Liu C. Hysteroscopic surgery of ectopic pregnancy in the cesarean section scar. J Minim Invasive Gynecol 2009; 16:432–6.
  • 23- Wang CJ, Yuen LT, Chao AS, Lee CL, Yen CF, Soong YK. Caesarean scar pregnancy successfully treated by operative hysteroscopy and suction curettage. BJOG 2005; 112:839e40
  • 24- Wang CJ, Chao AS, Yuen LT, Wang CW, Soong YK, Lee CL. Endoscopic management of cesarean scar pregnancy. Fertil Steril 2006; 85:494–7.
  • 25- Wang YL, Su TH, Chen HS. Laparoscopic management of an ectopic pregnancy in a lower segment cesarean section scar: a review and case report. J Minim Inv Gynecol 2005; 12:73–9.
  • 26- Wang YL, Su TH, Chen HS. Operative laparoscopy for unruptured ectopic pregnancy in a caesarean scar. BJOG 2006; 113:1035–8.
  • 27- Wang JH, Xu KH, Lin J, Xu JY, Wu RJ. Methotrexate therapy for cesarean section scar pregnancy with and without suction curettage. Fertil Steril 2009; 92:1208–13.
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Toplam 100 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Derleme
Yazarlar

Talip Karaçor 0000-0003-1349-1569

Berna Dilbaz 0000-0003-1137-8650

Mehmet Bülbül

Yayımlanma Tarihi 31 Mart 2019
Kabul Tarihi 26 Mart 2018
Yayımlandığı Sayı Yıl 2019 Cilt: 28 Sayı: 1

Kaynak Göster

AMA Karaçor T, Dilbaz B, Bülbül M. Sezaryen Skar Yeri Ektopik Gebeliği. aktd. Mart 2019;28(1):28-40.