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Ectopic Pregnancy Within a Cesarean Scar: A Review

Fylstra, Donald L. MD

Obstetrical & Gynecological Survey: August 2002 - Volume 57 - Issue 8 - p 537-543
CME Program: Category 1 CME Review Articles 22, 23, and 24

Implantation of a pregnancy within the scar of a previous cesarean delivery is the rarest of ectopic pregnancy locations. Only 19 cases have been reported in the English medical literature since 1966. If diagnosed early, treatment options are capable of preserving the uterus and subsequent fertility. However, a delay in either diagnosis or treatment can lead to uterine rupture, hysterectomy, and significant maternal morbidity. Although expectant and medical managements have been reported, termination of a cesarean scar pregnancy by laparotomy and hysterotomy, with repair of the accompanying uterine scar dehiscence, may be the best treatment option.

Target Audience: Obstetricians & Gynecologists, Family Physicians

Learning Objectives: After completion of this article, the reader will be able to define the entity of an ectopic pregnancy within a cesarean delivery scar, to list the ultrasound findings used to make the diagnosis of an ectopic pregnancy within a cesarean delivery scar, and to outline a potential management plan for a patient with an ectopic pregnancy within a cesarean delivery scar.

Associate Professor of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina

Reprint requests to: Donald L. Fylstra, MD, Associate Professor of Obstetrics and Gynecology, Medical University of South Carolina, CSB 634F, 96 Jonathan Lucas Street, Charleston, South Carolina 29425. Email: fylstrad@musc.edu

The author has disclosed no significant financial or other relationship with any commercial entity.

© 2002 Lippincott Williams & Wilkins, Inc.