Successful surgical treatment of a case with complicated Cesarean scar pregnancy

مقدمه : Cesarean scar pregnancy (CSP) refers to a pregnancy that is implanted on or in a scar from a prior cesarean birth. If unrecognized or inadequately managed, CSP can lead to severe maternal morbidity (eg, uterine rupture, hemorrhage) and mortality. CSP occurs in approximately ۱ in ۲۰۰۰ pregnancies and appears to be rising in past years.هدف : Case presentation of a complicated case with CSPمعرفی بیمار : A ۲۸ years old woman came to gynecology clinic of Kamali hospital with complain of vaginal bleeding and abdominal pain. She is G۳P۲L۱IUFD۱, with a history of two previous Cesarean section and gestational age of ۱۰ weeks in current pregnancy.The vital signs of patient in the clinic was: BP=۱۱۰/۷۰, PR=۹۰, RR=۱۹, T=۳۷.۲ and BMI=۲۸In the examination there were no acute abdominal symptoms and the vaginal bleeding was at the level of spotting. The patient has an ultrasound with a report of missed abortion in inferior segment of uterus. The patient admitted in gynecology department of Kamali hospital and after confirming the diagnosis with re_ultrasound, medical treatment of missed abortion with Misoprostol tablet was started. Due to the patient’s lack of response to ۷۲ hours medical treatment, the plan of surgical treatment was made. In the operation room the patient underwent curettage but due to continuous severe bleeding she underwent emergency laparotomy. As can be seen in picture number ۱ and ۲, there was a mass lesion measuring ۵*۵ cm in the lower segment of uterus. Wedge resection surgery was performed for the patient. Fortunately the patient was discharged from the hospital without any complication and in good general condition.

کلیدواژه ها:

Cesarean Scar Pregnancy ، Surgical treatment