Olgu Sunumu
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Sezeryan skar gebeliğin metotreksat ile lokal tedavisi: Bir olgu sunumu

Yıl 2022, Cilt: 47 Sayı: 1, 459 - 462, 31.03.2022

İlknur Okur Akşan Nilhan Öztürk Dilek Yeniay

https://doi.org/10.17826/cumj.999200

Öz

Sezaryen skar gebeliği, önceki sezaryen skarının yanında myometrium içine gebelik kesesinin yerleşmesidir, nadir görülen bir dış gebelik türüdür. Ultrason ilk ve en önemli tanı yöntemidir. Artan şüphe ve ultrasonun yaygın kullanımı çoğu sezaryen skar ektopik gebelik vakasının erken gebelik döneminde tanınmasına neden olur.Bu da hızlı müdahalelere, uterusun ve fertilitenin korunmasına olanak sağlar. Metotreksat ile medikal tedaviyi de içeren konservatif tedavilerin kullanılması, histerektomi gibi ameliyatlardan kurtarır ve kadınların fertilitesini korur. Bu yazıda 37 yaşında daha önce 3 sezeryan operasyonu geçirmiş sezaryen skar ektopik gebeliği olan hastanın transvajinal ultrason rehberliğinde metotreksat enjeksiyonu ile lokal olarak tedavisi olan olgu sunulmuştur.

Anahtar Kelimeler

skar gebelik metotreksat sezeryan ultrason

Kaynakça

  • Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management . Obstet Gynecol. 2006, 107:1373-81.
  • Ash A, Smith A, Maxwell D. Caesarean scar pregnancy. BJOG. 2007, 114:253-63.
  • Jurkovic D, Hillaby K, Woelfer B, Lawrence A, Salim R, Elson CJ. First-trimester diagnosis and management of pregnancies implanted into the lower uterine segment Cesarean section scar. Ultrasound Obstet Gynecol. 2003;21:220-7.
  • Vial Y, Petignat P, Hohlfeld P. Pregnancy in a cesarean scar. Ultrasound Obstet Gynecol. 2000;16:592-3.
  • Mohapatra I, Samantray SR. Scar ectopic pregnancy - an emerging challenge. Cureus. 2021;13:e16673.
  • Samantaray SR, Mohapatra I, Vivekanada A. A clinical study of ectopic pregnancy at a tertiary care centre in Telangana, India. Int J Reprod Contracept Obstet Gynecol. 2020;9:682-87.
  • Larsen JV, Solomon MH. Pregnancy in a uterine scar sacculus-an unusual cause of postabortal haemorrhage. A case report. S Afr Med J. 1978;53:142-3.
  • Fylstra DL. Ectopic pregnancy within a cesarean scar: a review. Obst Gynecol Surv. 2002;57:537-43.
  • Mohapatra I, Samantaray SR, Vivekanand A, Manjula A , Priyanka B. Analysis of caesarean sections at a tertiary care centre according to Robson’s criteria. Int J Reprod Contracept Obstet Gynecol. 2020;9:3445-48.
  • Shen L, Tan A, Zhu H, Guo C, Liu D, Huang W. Bilateral uterine artery chemoembolization with methotrexate for cesarean scar pregnancy. Am J Obstet Gynecol. 2012;207:386.e1-6.
  • Abbas A, Ali S, Nagy M, Nasif F. Accidental diagnosis and conservative management of a case of first-trimester cesarean scar ectopic pregnancy. Int J Reprod Contracept Obstet Gynecol. 2018;7:1628-30.
  • Godin PA, Bassil S, Donnez J. An ectopic pregnancy developing in a previous caesarian section scar. Fertil Steril. 1997;67:398-400.
  • Vial Y, Petignat P, Hohlfeld P. Pregnancy in a cesarean scar. Ultrasound Obstet Gynecol. 2000;16:592-3.
  • Seow KM, Hwang JL, Tsai YL. Ultrasound diagnosis of a pregnancy in a Cesarean section scar . Ultrasound Obstet Gynecol. 2001;18:547-49.
  • Glenn TL, Bembry J, Findley AD, Yaklic JL, Bhagavath B, Gagneux P et al. Cesarean scar ectopic pregnancy: current management strategies. Obstet Gynecol Surv. 2018;73:293-302.
  • Calì G, Timor-Tritsch IE, Palacios-Jaraquemada J, Monteaugudo A, Buca D, Forlani F et al. Outcome of cesarean scar pregnancy managed expectantly: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2018;51:169-175.
  • Aydeniz EG, Sarı U, Dilek TUK. Cesarean scar pregnancies and their management: case series. Perinatal Journal. 2018;26:155–161.

Local treatment with methotrexate of cesarean scar pregnancy: A case report

Yıl 2022, Cilt: 47 Sayı: 1, 459 - 462, 31.03.2022

İlknur Okur Akşan Nilhan Öztürk Dilek Yeniay

https://doi.org/10.17826/cumj.999200

Öz

Cesarean scar pregnancy, is the implantation of a gestational sac within the myometrium at the side of previous cesarean section scar, is a rare type of ectopic pregnancy. Ultrasonography is the first and most important diagnostic method of this condition. Increased suspicion with widespread use of ultrasound lead to the recognition of most cases of Cesarean scar pregnancy in early pregnancy. This allows for rapid interventions and preservation of the uterus and fertility. The use of conservative treatments, including medical treatment, especially with methotrexate, saves from surgeries such as hysterectomy and preserves women's fertility. In this study, we presented a case of cesarean scar pregnancy which was successfully treated with transvaginal ultrasound-guided injection of methotrexate.

Anahtar Kelimeler

Scar pregnancy methotrexate, cesarean section, ultrasound

Kaynakça

  • Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management . Obstet Gynecol. 2006, 107:1373-81.
  • Ash A, Smith A, Maxwell D. Caesarean scar pregnancy. BJOG. 2007, 114:253-63.
  • Jurkovic D, Hillaby K, Woelfer B, Lawrence A, Salim R, Elson CJ. First-trimester diagnosis and management of pregnancies implanted into the lower uterine segment Cesarean section scar. Ultrasound Obstet Gynecol. 2003;21:220-7.
  • Vial Y, Petignat P, Hohlfeld P. Pregnancy in a cesarean scar. Ultrasound Obstet Gynecol. 2000;16:592-3.
  • Mohapatra I, Samantray SR. Scar ectopic pregnancy - an emerging challenge. Cureus. 2021;13:e16673.
  • Samantaray SR, Mohapatra I, Vivekanada A. A clinical study of ectopic pregnancy at a tertiary care centre in Telangana, India. Int J Reprod Contracept Obstet Gynecol. 2020;9:682-87.
  • Larsen JV, Solomon MH. Pregnancy in a uterine scar sacculus-an unusual cause of postabortal haemorrhage. A case report. S Afr Med J. 1978;53:142-3.
  • Fylstra DL. Ectopic pregnancy within a cesarean scar: a review. Obst Gynecol Surv. 2002;57:537-43.
  • Mohapatra I, Samantaray SR, Vivekanand A, Manjula A , Priyanka B. Analysis of caesarean sections at a tertiary care centre according to Robson’s criteria. Int J Reprod Contracept Obstet Gynecol. 2020;9:3445-48.
  • Shen L, Tan A, Zhu H, Guo C, Liu D, Huang W. Bilateral uterine artery chemoembolization with methotrexate for cesarean scar pregnancy. Am J Obstet Gynecol. 2012;207:386.e1-6.
  • Abbas A, Ali S, Nagy M, Nasif F. Accidental diagnosis and conservative management of a case of first-trimester cesarean scar ectopic pregnancy. Int J Reprod Contracept Obstet Gynecol. 2018;7:1628-30.
  • Godin PA, Bassil S, Donnez J. An ectopic pregnancy developing in a previous caesarian section scar. Fertil Steril. 1997;67:398-400.
  • Vial Y, Petignat P, Hohlfeld P. Pregnancy in a cesarean scar. Ultrasound Obstet Gynecol. 2000;16:592-3.
  • Seow KM, Hwang JL, Tsai YL. Ultrasound diagnosis of a pregnancy in a Cesarean section scar . Ultrasound Obstet Gynecol. 2001;18:547-49.
  • Glenn TL, Bembry J, Findley AD, Yaklic JL, Bhagavath B, Gagneux P et al. Cesarean scar ectopic pregnancy: current management strategies. Obstet Gynecol Surv. 2018;73:293-302.
  • Calì G, Timor-Tritsch IE, Palacios-Jaraquemada J, Monteaugudo A, Buca D, Forlani F et al. Outcome of cesarean scar pregnancy managed expectantly: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2018;51:169-175.
  • Aydeniz EG, Sarı U, Dilek TUK. Cesarean scar pregnancies and their management: case series. Perinatal Journal. 2018;26:155–161.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Olgu Sunumu
Yazarlar

İlknur Okur Akşan 0000-0002-4582-9555

Nilhan Öztürk 0000-0002-6826-0170

Dilek Yeniay 0000-0002-1838-2022

Yayımlanma Tarihi 31 Mart 2022
Kabul Tarihi 14 Kasım 2021
Yayımlandığı Sayı Yıl 2022 Cilt: 47 Sayı: 1

Kaynak Göster

MLA Okur Akşan, İlknur vd. “Local Treatment With Methotrexate of Cesarean Scar Pregnancy: A Case Report”. Cukurova Medical Journal, c. 47, sy. 1, 2022, ss. 459-62, doi:10.17826/cumj.999200.
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