ABSTRACT Myometrial pregnancy developing in a previous caesarean section scar is the rarest of all ectopic pregnancies (EP) and probably one of the most dangerous of all because of the risk of rupture and hemorrhage. The recent recognition of this problem means that diagnosis and management are still in their infancy, and there is no consensus regarding the best management of CSP. Methotrexate (MTX) can be administered systemically or locally, or in both ways, with the aid of ultrasound. Patients diagnosed with caesarean scar pregnancies (CSP) in our clinic underwent transvaginal treatment of ectopic pregnancy. Safe and short treatment under transvaginal ultrasonographic (USG) guidance was performed uneventfully in all cases. The operating time ranged from 5 to 10 minutes with no blood loss. Serum β-hCG (β-subunit of human chorionic gonadotrophin) levels declined to normal levels within a month, and patients were discharged without further complications in two or three hours after the procedure. Our cases show that this treatment is effective, safe, and minimally invasive for patients diagnosed with CSP.
Cite this paper
Güven, D. , Bakay, K. and Batıoğlu, A. (2012) Local metothrexate treatment of cesarean scar ectopic pregnancy. Open Journal of Obstetrics and Gynecology, 2, 329-330. doi: 10.4236/ojog.2012.24069.
 Pierre-Arnaud, G., Salim, B. and Jacques, D. (1997) An ectopic pregnancy developing in a previous caesarian section scar. Fertility and Sterility, 65, 398-400.
 Rebecca, D. and Jason, A. (2010) Hysteroscopic management of cesarean scar ectopic Pregnancy. Fertility and Sterility, 93, 1735-1740.
 Batioglu, S., Haberal, A., Yesilyurt, H. and Ekici, E. (1997) Successful treatment of cornual pregnancy by local injection of methotrexate underlaparoscopic and transvaginal ultrasonographicguidance. Gynecologic and Obstetric Investigation, 44, 64-66. doi:10.1159/000291413
 Homayoun, S., Thomas, R., Beth, W. R., Katherine, H. C., Christina, M. D., Marsha, K. G., Pinar, H. K. and Errol, R. N. (2010) Cesarean scar ectopic pregnancy: Case series and review of the literature. American Journal of Perinatology, 27, 111-120. doi:10.1055/s-0029-1224874
 Rotas, M., Haberman, S. and Levgur, M. (2006) Cesarean scar ectopic pregnancies etiology, diagnosis and management. Obstetrics & Gynecology, 107, 1373-1381.