Volume 13, Issue 7 (9-2015)                   IJRM 2015, 13(7): 445-450 | Back to browse issues page

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Pirjani R, Bayani L, Shirazi M. Successful local and systemic medical treatment of cesarean scar pregnancy and a subsequent term pregnancy after treatment: a case series. IJRM 2015; 13 (7) :445-450
URL: http://ijrm.ir/article-1-662-en.html
Successful local and systemic medical treatment of cesarean scar pregnancy and a subsequent term pregnancy after treatment: a case series
Reihaneh Pirjani1 , Leila Bayani2 , Mahboobeh Shirazi * 3
1- Department of Obstetrics and Gynecology, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran
2- Department of Radiology Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran
3- Maternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran , Mahboobeh.shirazi@yahoo.in
Abstract:   (3975 Views)
Background: Treatment of cesarean scar pregnancy (CSP) is controversial. The objective of this study was to report our successful experience in the medical treatment of CSP with potassium chloride (KCl) and methotrexate.
Case: This is a case series of six patients between 6-12 gestational weeks with the diagnosis of CSP.  In five cases the fetus was alive and in one case, despite being at a gestational age of 12 weeks based on CRL, there was no fetal heart activity. In four of these cases, an ultrasound- guided KCl injection in the heart was performed on four living fetuses and then systemic methotrexate was administered. In two other cases, methotrexate was injected into the gestational sac and subsequently the systemic methotrexate was administered. During follow-up, the patients were stable and no complications occurred. Additionally, serum beta human chorionic gonadotropin (β-hCG) was negative between five to 11 weeks later. One of the patients became pregnant one year later. Her pregnancy continued without any complication and she was delivered by cesarean section at the gestational age of 38 weeks. During caesarean section, it was noticed that the appearance of previous cesarean scar was normal and there was no scar.
Conclusion: Based on our experience, the combination of systemic Methotrexate with local Methotrexate or KCl is feasible and can be performed as an outpatient procedure and is successful in the treatment of CSP.
Keywords: Cesarean, Ectopic pregnancy, Potassium chloride, methotrexate.
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Type of Study: Original Article |
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