Cesarean scar pregnancy treated with methotrexate and dilatation-currettage: Case report Deniz Cemgil Arıkan 1, Emre Turgut 2, Gürkan Kıran 1, Hakan Kıran 1 1 - Sütçü Imam University School of Medicine, Department of Obstetrics and Gynecology, Kahramanmaras, Turkey 2 - Istanbul Education and Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey
Dicle Med J 2012; 39(1):102-104 ICID: 987120
Article type: Case report
IC™ Value: 1.80
Abstract provided by Publisher
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.