Pregnancy in a previous cesarean section scar: Case report
DOI:
https://doi.org/10.35434/rcmhnaaa.2024.172.2379Keywords:
Cesarean section, Scar, PregnancyAbstract
Cesarean section represents a procedure whose frequency has increased over time. As a consequence of this history, a complication of pregnancy is reported, the previous cesarean scar pregnancy (PCBS). Some include it as a type of ectopic pregnancy, most do not as such. This complication represents implantation of the blastocyst in a scar defect, described as isthmocele. ECCP can be of two types. The endogenous or type 1, where the gestational sac grows towards the uterine cavity and therefore the myometrium will be thicker; and the exogenous or type 2, with a growth towards the bladder, where the myometrium is very thinned. The management of this pathology is not standardized. Because of the severe maternal morbidity that can occur, and the still controversial management, we report a clinical case managed surgically at the Hospital Nacional Dos de Mayo.
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Rodríguez Ortiz JA, Díaz RA, Daza MM, Hernández S, Díaz C, Luna PA. Embarazo ectópico en cicatriz de cesárea: reporte de caso y revisión de la literatura. Hospital Simón Bolívar subred norte Bogotá, Colombia. Revista Med [Internet]. 2021 Jun 4 [cited 2023 Sep 16];28(2):103–10. Available from: http://www.scielo.org.co/pdf/med/v28n2/1909-7700-med-28-02-103.pdf
Ban Y, Shen J, Wang X, Zhang T, Lu X, Qu W, et al. Cesarean Scar Ectopic Pregnancy Clinical Classification System With Recommended Surgical Strategy. Obstet Gynecol [Internet]. 2023 May 1 [cited 2023 Aug 9];141(5):927–36. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10108840/pdf/ong-141-927.pdf
Pardina Pueyo SI, Alcalá-Santaella D, Jaén Zamora MJ. Gestación ectópica en cicatriz de cesárea previa con desenlace adverso. Prog Obstet Ginecol [Internet]. 2022 [cited 2023 Aug 9];65:81–5. Available from: https://www.mendeley.com/reference-manager/reader-v2/bafe93e4-61b9-3cc2-8a6d-6d7d78bf3bdd/6b1135f0-a686-fe9f-6895-018e03d7629d
Tipiani-Rodriguez O, Elías-Estrada JC, Bocanegra-Becerra YL, Ponciano-Biaggi MÁ. Tratamiento del embarazo ectópico implantado en cicatriz de cesárea: estudio de cohorte 2018-2022, Lima, Perú. Rev Colomb Obstet Ginecol [Internet]. 2023 [cited 2023 Aug 9];74(2):128-35. Available from: http://www.scielo.org.co/pdf/rcog/v74n2/2463-0225-rcog-74-02-3958.pdf
Morente LS, León AIG, Reina MPE, Herrero JRA, Mesa EG, López JSJ. Cesarean scar ectopic pregnancy—case series: Treatment decision algorithm and success with medical treatment. Medicina (Lithuania) [Internet]. 2021 Apr 1 [cited 2023 Sep 16];57(4). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068280/pdf/medicina-57-00362.pdf
Miller R, Gyamfi-Bannerman C. Society for Maternal-Fetal Medicine Consult Series #63: Cesarean scar ectopic pregnancy. Am J Obstet Gynecol [Internet]. 2022 Sep 1 [cited 2023 Sep 23];227(3):B9–20. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0002937822004781
Pradillo A T, Sevilla R J, Valdés R ML, Pérez C E, Fraga C S, González R M, et al. Tratamiento del embarazo ectópico en cicatriz de cesárea. Revisión de la literatura a propósito de 3 casos. Rev Chil Obstet Ginecol [Internet]. 2021 [cited 2023 Aug 7];86(1):104–19. Available from: https://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-75262021000100104
Xu Z, Sheng C, Yang Q, Wang J. Analysis of pregnancy outcomes following surgical treatment of cesarean scar pregnancy. BMC Pregnancy Childbirth [Internet]. 2022 Dec 1 [cited 2023 Sep 29];22(1). Available from: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-022-04965-9
Huo S, Shen L, Ju Y, Liu K, Liu W. Treatments for cesarean scar pregnancy: 11-year experience at a medical center. Journal of Maternal-Fetal and Neonatal Medicine [Internet]. 2023 [cited 2023 Sep 29];36(1). Available from: https://www.tandfonline.com/doi/epdf/10.1080/14767058.2022.2162818?needAccess=true
Lin Y, Xiong C, Dong C, Yu J. Approaches in the Treatment of Cesarean Scar Pregnancy and Risk Factors for Intraoperative Hemorrhage: A Retrospective Study. Front Med (Lausanne) [Internet]. 2021 Jun 24 [cited 2023 Sep 29];8(682368). Available from: https://www.frontiersin.org/articles/10.3389/fmed.2021.682368/full
Karakuş R, Karakuş SS, Güler B, Ünver G, Özkaya E. Myometrial thickness overlying cesarean scar pregnancy is significantly associated with isthmocele formation in the third month of the postoperative period. Journal of Turkish Society of Obstetric and Gynecology [Internet]. 2021 Mar 12 [cited 2023 Sep 17];18(1):37–43. Available from: http://cms.galenos.com.tr/Uploads/Article_46925/TJOG-18-37-En.pdf
Morlando M, Buca D, Timor-Tritsch I, Cali G, Palacios-Jaraquemada J, Monteagudo A, et al. Reproductive outcome after cesarean scar pregnancy: A systematic review and meta-analysis [Internet]. Vol. 99, Acta Obstetricia et Gynecologica Scandinavica. Wiley-Blackwell; 2020 [cited 2023 Sep 17]. 1278–1289 p. Available from: https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.13918
Zhang X, Pang Y, Ma Y, Liu X, Cheng L, Ban Y, et al. A comparison between laparoscopy and hysteroscopy approach in treatment of cesarean scar pregnancy. Medicine (United States) [Internet]. 2020 Oct 23 [cited 2023 Sep 16];99(43):E22845. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7581091/pdf/medi-99-e22845.pdf
Cassana A, Yanque O. Embarazo en cicatriz de cesárea previa: ¿Es siempre quirúrgico? Reporte de un caso. Anales de la Facultad de Medicina [Internet]. 2018 Mar 23 [cited 2023 Sep 16];78(4):430. Available from: http://www.scielo.org.pe/pdf/afm/v78n4/a11v78n4.pdf
Silva B, Viana Pinto P, Costa MA. Cesarean Scar Pregnancy: a systematic review on expectant management. European Journal of Obstetrics & Gynecology and Reproductive Biology [Internet]. 2023 Sep [cited 2023 Aug 9];288:36–43. Available from: https://www.ejog.org/action/showPdf?pii=S0301-2115%2823%2900272-5
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Copyright (c) 2024 José Luis Morales Bautista, Marianny Emilicelesty Salazar, Karina Roxana del Aguila-Salgado, Jorge Renato Aparicio-Ponce
This work is licensed under a Creative Commons Attribution 4.0 International License.
