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Reducing Bleeding in Cesarean Scar Pregnancy with Methotrexate: A Case Report

Year: 2025

Type: article

Abstract: Rising incidence of aggressive Cesarean Scar Pregnancy (CSP) lacks consensus treatment. This paper aims to evaluate the use of methotrexate in reducing bleeding in the management of CSP. Three cases of CSP, each managed with a distinct approach, are presented in this study. The first patient was diagnosed at 13 weeks of gestation. A hysterectomy was performed because of massive bleeding. The second patient had repeated CSP. The first CSP was diagnosed in six weeks, and curettage was performed. The patient had been bleeding for three months. CSP in the subsequent pregnancy was diagnosed at five weeks of gestational age, and the patient decided to terminate by systemic administration of methotrexate twice, followed by resection. Bleeding was minimal. Pregnant women must be screened as early as possible, especially in patients with a history of uterine wall injury, to rule out CSP. Methotrexate gives a better result for CSP management.

Source: Journal of Obstetrics Gynecology and Cancer Research

DOI: 10.24200/jogcr.10.12.1008

Authors: Deviana Soraya Riu, Efendi Lukas, Isharyah Sunarno, Mirah Avisha

Institutions: Rumah Sakit Umum Pusat Dr. Wahidin Sudirohusodo, Hasanuddin University

Language: English

Topic: Ectopic Pregnancy Diagnosis and Management

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funder: Universitas Hasanuddin