Conservative Management of Intramural Pregnancy Implanting in The Cesarean Section Scar.
- Author:
Hee Jin KIM
1
;
Kyoung Soon LEE
;
Mee Young HAN
;
Eun Hee LEE
;
Won Young CHOI
Author Information
1. Department of Obstetrics and Gynecology, Ilsin Christian Hospital, Busan, Korea.
- Publication Type:Original Article
- Keywords:
Ectopic pregnancy;
Intramural pregnancy;
Cesarean section scar;
Methotrexate
- MeSH:
Cesarean Section*;
Cicatrix*;
Curettage;
Dilatation and Curettage;
Female;
Hemorrhage;
Humans;
Methotrexate;
Pregnancy*;
Pregnancy, Ectopic;
Ultrasonography
- From:Korean Journal of Obstetrics and Gynecology
2004;47(9):1743-1747
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To evaluate of safety and effectiveness of conservative treatment of previous cesarean section scar pregnancy. METHODS: Ten patients with previous cesarean section scar pregnancy were treated systemic methotrexate or intra-amnionic methotrexate injection. After treatment, patients were measured for the levels of serum beta-hCG and underwent ultrasound. According to the results, additional dose of methotrexate or curettage were done. Serum beta-hCG and ultrasound were checked several times until the level of serum beta-hCG and the finding of ultrasound had been normalized. RESULTS: Two patients showed normal serum beta-hCG levels and ultrasound findings after intra-amnionic methotrexate injection only. Two patients showed normal serum beta-hCG levels and ultrasound findings after systemic methotrexate/folinic acid therapy followed by dilatation and curettage. Six patients showed normal serum beta-hCG levels and ultrasound findings after intra-amnionic methotrexate injection followed dilatation and curettage. Two patients were transfused due to massive bleeding and other patients were not experienced severe complications. CONCLUSION: These results suggest that systemic or intra-amnionic methotrexate therapy with or without dilatation and curettage is safe and effective as a primary therapy for intramural pregnancy implanting in the cesarean section scar.
