Medical Treatment in Cesarean Scar Pregnancy with Fetal Heart Activity and High Level of Serum β-hCG: A Case Report

Author(s): Nafiseh Saghafi, Leila Pourali*, Atiyeh Vatanchi, Zahra Rastin

Journal Name: Current Women`s Health Reviews

Volume 17 , Issue 2 , 2021


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Abstract:

Background: Cesarean scar pregnancy (CSP) is the implantation of the gestational sac in the hysterotomy scar. The optimal treatment for a cesarean scar pregnancy is unclear and therapy should be selected according to the patients' clinical presentation. The aim of this study was to report a successful medical treatment of a cesarean scar pregnancy with fetal heart activity and a very high level of beta-human chorionic gonadotropin (β-hCG).

Case Presentation: A 38-year-old woman referred for a routine prenatal visit after 2 months of menstrual retard and a positive pregnancy test. She had a history of 3 cesarean sections and a uterine curettage. Ultrasonography revealed cesarean scar ectopic pregnancy. The serum level of β-hCG was 109063 mIU/ml. Two doses of systemic methotrexate therapy and intragestational sac injection of methotrexate and potassium chloride were administered. Eight weeks after the initial treatment, the β-hCG level became undetectable.

Conclusion: Combined medical treatment with local and systemic MTX administration may be a successful treatment with low complications even in the presence of high serum β-hCG level.

Keywords: Cesarean section, ectopic pregnancy, methotrexate, serum β-hCG level, ultrasonography, uterine curettage.

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Article Details

VOLUME: 17
ISSUE: 2
Year: 2021
Published on: 17 September, 2020
Page: [185 - 188]
Pages: 4
DOI: 10.2174/1573404816999200917122124
Price: $65

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