Philippine E-Journals

A Life Away from Home: Pregnancy at the Caesarean Section Scar

Noemie M. Manzanero-galvan | Angelita R. Teotico

 

Abstract:

Pregnancy of the caesarean scar is one of the rare types of ectopic pregnancy. It is a pregnancy implanted on a previous Caesarean Section (CS) scar. The case presented aimed to report the demography, pathophysiology, clinical presentation, most appropriate methods of diagnosis and management, with their implications in clinical practice for this rare case of ectopic pregnancy. This is a 30 years of age Gravida 3 Para 1 (1-0-1-1) who developed pregnancy of the CS Scar after full term delivery via the abdominal route. Patient wanted to save her uterus contemplating for future pregnancy. Bioethics committee was consulted. A conservative management thru methotrexate injection was done. After the first cycle of the drug, there was no resolution of the placenta and a live pregnancy was noted. Patient was scheduled for another course of methotrexate therapy, but opted to undergo surgical hysterectomy. A thorough study on the best management of Cesarean scar pregnancy is needed in order to preserve fertility and reduce morbidity.