A. Dumitrescu, M.C. Tîrnovanu, D. Nemescu, A. Berescu, A. Carp, M. Onofriescu
Rezumat: The cesarean scar ectopic pregnancy
tends to become a pathology more and more frequently
encountered in the practice of obstetricians. The
early diagnosis by means of echography allows
the elaboration of various therapeutic strategies,
substantially improving the achieved results. The careful
monitoring of these patients through a detailed plan
represents one of the main objectives, having an impact
on fertility by the conservation of the uterus, and of
females’ health. An early echography in the case of
a woman with scar ectopic pregnancy in her history
would clarify the localization of implantation of the
new pregnancy and would allow the evaluation of the
uterine scar. The aim of this study is to present a case of
an ectopic pregnancy implanted in a previous uterine
scar diagnosed in the first trimester of pregnancy and
the efficiency of the therapeutic strategy required.
The 43-year-old patient, gravida 2, appeared
within our service, suspecting the diagnosis of cervical
ectopic pregnancy. Reduced genital bleeding and low
abdominal pain were objectified upon admission.
Endovaginal ultrasonography showed a 6-week ectopic
pregnancy with viable fetus and intact gestational sac,
implanted towards the former post-cesarean isthmic
scar. The determined therapeutic protocol approached
a medical and surgical management.
The cesarean scar pregnancy does not have specific
symptoms and may be easily misdiagnosed. Cuvinte cheie: transvaginal sonography, methotrexate,
cesarean scar pregnancy, uterine rupture.