Journal of Fertilization: In Vitro - IVF-Worldwide, Reproductive Medicine, Genetics & Stem Cell Biol
Open Access

Abstract

Management of the Ectopic Pregnancy Located at the Level of the Uterine Scar

Saceanu Maria Sidonia, Cristian Vaduva, Alexandru Comanescu, Andreea Veliscu, Cristina Comanescu and Anca Patrascu

The ectopic pregnancy located on a uterine scar is basically defined as implantation of the gestational sac at the level of the fibrous tissue of a uterine scar. The incidence of this pathology varies a lot, it can reach up to 1 case in 2000 ectopic pregnancies. It is expected that the incidence will increase. In the case of ectopic pregnancy, there were many therapeutic, medications or surgical (radical or conservative) options.

Case report: We are presenting a prospective study conducted over a period of 26 months from July 2012 to September 2014 in Craiova Emergency County Hospital. This article reports 2 cases diagnosed with ectopic Pregnancy Located at the Level of the Uterine scar. The first case is of a 26-year-old patient, 4 pregnancies, 1 birth, who came to the Gynaecology practice due to 6-week amenorrhoea, pelvic pain, low vaginal bleeding. Following the discussion with the patient, the conservative drug therapy was initiated, namely, she was given methotrexate 50 mg/m2. The patient showed no side effects after the methotrexate. The second case is of a 31-year-old patient, 2 pregnancies, 1 birth, who came to the gynecology practice due to 4-5 week amenorrhoea, pelvic pain, vaginal bleeding. Following the discussion with the patient, the decision was made to conduct the hemostatic and evacuation uterine curettage under transrectal ultrasound control in order to minimize the risk of perforation. The uterine curettage was performed in a classic way. No complications were reported during the procedure or in the recovery period.

Conclusion: Ectopic pregnancy located in the uterine trance can be successfully treated with medicine, but it is preferable that in the case of patients who still want to have a baby, the trance to be repaired by means of surgery to minimize the risks and a recurrence of this pathology.