Year: 2023
Type: conference-abstract
Abstract: Scar pregnancy is a rare form of ectopic pregnancy with the fertilised egg implanted in the uterine muscle or the fibrous scar tissue of a previous Caesarean section. It is a serious and potentially life-threatening condition. The aim of this study is to describe the importance of endovaginal ultrasound as a diagnosis and management tool of scar pregnancies. We conducted a descriptive, retrospective monocentric study in our department over a 4-year period (2019-2022). All patients admitted for a suspected scar pregnancy during that period were enrolled and their clinical characteristics in addition to the ultrasound findings and the management strategies are reported. The study included 21 cases. The average age of our patients was 32.9 [22-41]. The mean number of Caesareans was 1.65 [1-5]. The main reason for consultation was metrorrhagia followed by pelvic pain. The mean gestational age was 10 weeks of amenorrhea [6-14]. No patient had an MRI to confirm the diagnosis. Ultrasound-guided metotrexate injection followed by ultrasound-guided aspiration 48 hours later was the option chosen in 57% (12) of the cases. The scar pregnancy was complicated by a hemorrhagic shock requiring hysterectomy in 14% (3) of the cases. A placenta accreta was histologically diagnosed in 2 of those cases. The duration of hospital stay was significantly longer for patients treated with in situ methotrexate with no aspiration. The average time for the negativation of β-hCG is 7.8 weeks [4.6- 13.2]. Scar pregnancy is an iatrogenic developing entity. It is a potentially life-threatening illness. Early detection and diagnosis with endovaginal ultrasound are essential to consider adapted treatment.
DOI: 10.1002/uog.27170
Authors: O. Kaabia, B. Chemli, S. Ernez, A. Chaieb
Institutions: Hôpital Farhat Hached, University of Sousse
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4387260293