Cesarean scar ectopic pregnancy: Do ultrasound play a cornerstone in its diagnosis and management?

Mohamed, Elshaimaa M.; Alayouty, Nader Ali; Refaat, Mona Mohammed

doi:10.21608/zumj.2022.146736.2591

Cesarean scar ectopic pregnancy: Do ultrasound play a cornerstone in its diagnosis and management?

Document Type : Original Article

Authors

¹ Radiodiagnosis department faculty of medicine Zagazig university Zagazig Egypt

² Radiodiagnosis, faculty of medicine, zagazig university Elsharkia government

³ radiodiagnosis,faculty of medicine,zagazig university,egypt

10.21608/zumj.2022.146736.2591

Abstract

Background: Cesarean scar due to ectopic pregnancy is an exceptional subtype of ectopic pregnancy that results in a critical life-threatening outcome. Prompt diagnosis with sonography can restrict maternal mortality. Local injection of methotrexate under sonographic guidance looks to be an actual substitute modality for its management. The goal of this research is to highlight the task of US and MRI in the diagnosis and interventional radiological management of this ectopic pregnancy.
Methods: This study included thirteen pregnant females in the first trimester diagnosed with CSP, their ages range from 28-41 years with a mean age of 34.6±4.3.
It was carried out in the period from February 2014 to November 2021.
All thirteen patients were examined by pelvic ultrasound and only two of them required complementary MRI study.
Results: The mean thickness of the myometrium between the sac and urinary bladder in all our cases by pelvic ultrasound was 2.4±0.9 mm. Only two cases had a suspicion of marked myometrial thinning with questionable urinary bladder invasion. Among thirteen cases, twelve were managed conservatively, nine of them treated by local MTX and potassium chloride injection under ultrasound guidance. Three cases were managed by dilatation and curettage under intra-operative ultrasound guidance.
Conclusions: Pelvic ultrasound has a magic role in the diagnosis of CSP and its management. Either local injection of MTX and KCL or D&C under ultrasound guidance consider successful conservative modalities with significant radiology incorporation.

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