1/58. Laparoscopic management of an ectopic pregnancy in a previous Caesarean section scar.A case of laparoscopic management of an ectopic pregnancy in a previous Caesarean section scar is reported. A 30 year old woman was admitted to our hospital for profuse vaginal bleeding 2 weeks after an abortion had been performed. A urine pregnancy test was positive. Abdominal ultrasound revealed a well-encapsulated bulging mass over the lower anterior uterine wall measuring 7x5 cm. hysteroscopy revealed retained gestational tissue in the lower corpus despite a normal uterine cavity. An incision was made over the most prominent area of the mass by operative laparoscopy. Dark reddish tissue suggestive of the products of conception was removed using grasping forceps. One-layer of continuous endoscopic sutures along the affected uterine wall was made with 1-0 Prolene. laparoscopy enabled the successful treatment of an unruptured ectopic pregnancy in a previous Caesarean scar and made it possible to preserve the patient's reproductive capability.- - - - - - - - - - ranking = 1keywords = pregnancy, gestation (Clic here for more details about this article) |
2/58. Scar formation after skin injury to the human foetus in utero or the premature neonate.A macroscopically visible scar was present at birth in three infants with a history of injury during amniocentesis at 16-20 weeks' gestation. In several neonates born between 21 and 31 weeks' gestation, chemical injury to the skin caused by extravasation of calcium gluconate healed by formation of a large scar. In the infant born at 21 weeks, biopsy of the injured area showed infiltration by large numbers of neutrophils and macrophages. It appears that a very immature neonate can mount a prominent inflammatory reaction and that both a midtrimester foetus and a very immature neonate heal injuries to the skin by scar formation and not by scarless healing.- - - - - - - - - - ranking = 0.039154180156103keywords = gestation (Clic here for more details about this article) |
3/58. Desmoid tumor arising in a cesarean section scar during pregnancy: monitoring and management.Desmoid tumors (DTs) are frequently associated with either surgical trauma, like scars, or physiologic trauma, like pregnancy. A DT arising in a cesarean scar during pregnancy shows both correlations. A case of DT that grew gradually in a cesarean scar during the first trimester of a subsequent pregnancy is presented. After initial MR imaging, the lesion was biopsied and carefully monitored; immediate surgical removal was considered at any time if indicated by the follow-up results. No increase in the tumor size was observed during the following 6 months of gestation, and the lesion was extirpated with mesh replacement of the abdominal defect at the time of cesarean section.- - - - - - - - - - ranking = 1keywords = pregnancy, gestation (Clic here for more details about this article) |
4/58. methotrexate for cesarean scar pregnancy after in vitro fertilization and embryo transfer. A case report.BACKGROUND: Cesarean scar pregnancy is an exceedingly rare occurrence. We present the first case of cesarean scar pregnancy following in vitro fertilization-embryo transfer (IVF-ET). CASE: A 40-year-old woman with a history of a previous cesarean section presented with five years of unexplained infertility. The patient complained of abdominal pain 16 days after embryo transfer. ultrasonography revealed a gestational sac with cardiac activity located outside the lower segment of the uterus. dilatation and curettage was performed due to misdiagnosis of inevitable abortion. Two weeks later, repeated sonography demonstrated a sacculus, 4.07 x 4.07 cm, within the uterine isthmus with only 7.1 mm of thickness separating the sac from the urinary bladder. Normal cervical length without ballooning was noted. Cesarean scar pregnancy was diagnosed. Local injection of methotrexate (MTX) under ultrasound guidance was performed. plasma beta-hCG levels declined from 23,328 to 8 mlU/mL within two months. CONCLUSION: For women with cesarean scar pregnancy who desire fertility, conservative treatment using MTX is an excellent choice.- - - - - - - - - - ranking = 1.1400604157031keywords = pregnancy, gestation (Clic here for more details about this article) |
5/58. Fetal survival despite unrecognized uterine rupture resulting from previous unknown corporeal scar.Cesarean scar rupture of a gravid uterus with unknown corporeal scar is common. Our case was a 35 year woman, gravida 2, para 1 presented at 38 weeks gestation. She was admitted to our hospital for routine follow up. She had no signs or symptoms of labor. However eight hours after the initial examination, she came back to hospital with the signs of shock and acute abdomen. Immediately she was referred to surgery. Intraoperatively a complete rupture of the classical corporeal incision was observed, but the fetus was enclosed within the anterior lying plasenta. The fetus was delivered with one minute apgar score 3, and five minute apgar score 8. According to this case, we conclude that spontaneous uterine rupture of the classical uterine scar can be observed even without uterine contractions. So women with the possibility of previous classical uterine incision should be delivered once fetal maturity is documented.- - - - - - - - - - ranking = 0.019577090078052keywords = gestation (Clic here for more details about this article) |
6/58. Multiple-dose methotrexate for pregnancy in a cesarean section scar. A case report.BACKGROUND: pregnancy developing in a cesarean section scar is a very rare but possibly life-threatening condition because of the risk of rupture and excessive hemorrhage. CASE: A woman with previous cesarean section had transvaginal sonography performed at 7 weeks of gestation that showed a gestational sac implanted in the anterior isthmus wall of the uterus with 3 mm of myometrium between the sac and bladder wall. A diagnosis of pregnancy in the cesarean section scar was made. The patient was asymptomatic, and her hemodynamic condition was stable. Two courses of multiple-dose systemic methotrexate-folinic acid (1 mg/kg methotrexate intramuscularly on days 1, 3, 5 and 7 with 0.1 mg/kg folinic acid intramuscularly on days 2, 4, 6 and 8) were given. The patient tolerated it and remained stable during treatment. The serum hCG dropped to < 5 IU/L on day 56. CONCLUSION: Treatment with methotrexate is a non-surgical option that can improve preservation of the uterus in patients who desire fertility. A multiple-dose regimen causes rapid interruption of the pregnancy. This is very important because the risk of rupture and hemorrhage directly correlates with the duration of the pregnancy.- - - - - - - - - - ranking = 1.0195770900781keywords = pregnancy, gestation (Clic here for more details about this article) |
7/58. Conservative treatment by chemotherapy and uterine arteries embolization of a cesarean scar pregnancy.We report a case of a viable cesarean scar pregnancy diagnosed at 7 weeks of gestation. The patient was conservatively managed by chemotherapy, intra-amniotic instillation of potassium chloride, and bilateral uterine artery embolization. The gestational sac was not sonographically visible 44 days after the treatment. No surgical treatment was necessary.- - - - - - - - - - ranking = 0.73945625867178keywords = pregnancy, gestation (Clic here for more details about this article) |
8/58. Conservative management of two ectopic pregnancies implanted in previous uterine scars.cesarean section scar pregnancy is rare. A variety of interventions have been implemented to terminate the pregnancy and preserve the uterus; however, the optimal treatment is unknown. We describe two cases of this rare condition diagnosed by transvaginal ultrasound. In the first case the diagnosis of an 8-week non-viable gestation in a uterine scar was made sonographically in a 40-year-old woman. The patient was treated with intramuscular methotrexate. Myometrial integrity was suggested both by ultrasound findings and laparoscopic findings. In the second case, an early cervicoisthmic pregnancy in a uterine scar was diagnosed by sonography in a 39-year-old woman. This patient was treated successfully with a full course of intramuscular methotrexate. Complete disappearance of the gestational sac took place 4 months following beta-human chorionic gonadotrophin normalization. Intramuscular methotrexate may be a treatment alternative for cesarean section scar pregnancies.- - - - - - - - - - ranking = 0.45933542726551keywords = pregnancy, gestation (Clic here for more details about this article) |
9/58. Ectopic pregnancy within a cesarean delivery scar: a case report.The implantation of a pregnancy within the scar of a previous cesarean delivery is the rarest of ectopic pregnancy locations. If it is 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.- - - - - - - - - - ranking = 0.84036249421881keywords = pregnancy (Clic here for more details about this article) |
10/58. Successful management of a heterotopic Caesarean scar pregnancy: potassium chloride injection with preservation of the intrauterine gestation: case report.Caesarean scar pregnancy (CSP), in which the pregnancy is located in the scar of a previous Caesarean section, is a rare situation that carries a high risk of uterine rupture. Improved ultrasound imaging allows early diagnosis of this condition, but there is no standard management. We report the first case of CSP associated with a normal intrauterine pregnancy. potassium chloride administered under transvaginal ultrasonographic guidance terminated cardiac activity in the CSP. The CSP resolved, and a healthy infant was delivered at 36 weeks. When the diagnosis is early and the patient asymptomatic, surgery can be avoided, the CSP can be terminated selectively and the intrauterine pregnancy thereby preserved.- - - - - - - - - - ranking = 1.1987916859373keywords = pregnancy, gestation (Clic here for more details about this article) |
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