Author/Authors :
Aksüt, Hayri Katip Çelebi Üniversitesi - Tıp Fakültesi, Atatürk Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, Turkey , Yılmaz, Bülent Katip Çelebi Üniversitesi - Tıp Fakültesi, Atatürk Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, Turkey , Mavi, Şadiye Katip Çelebi Üniversitesi - Tıp Fakültesi, Atatürk Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, Turkey , Soylu, Ferit Katip Çelebi Üniversitesi - Tıp Fakültesi, Atatürk Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, Turkey , Yalçın, Yakup Katip Çelebi Üniversitesi - Tıp Fakültesi, Atatürk Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, Turkey
Abstract :
Cesarean scar pregnancy is a rare form of ectopic pregnancy and seen aproximately 1 in 2200 cases. The operations that are applied to the uterus are known as the pathophysiological cause. Transvaginal ultrasound is the best efficacious method for diagnosis. Many therapeutic options such as dilatation and curettage, uterine artery embolization, laparatomy, laparoscopy, hysterectomy, and preventetive surgery, local or systemically administered methotrexate, KCL are available. In this paper, a case of cesarean scar pregnancy presenting with acute abdomen after coitus is presented. A 29 year-old woman, gravidity 2, parity 1, alive 1 was admitted to hospital with a severe abdominal pain that occured after coitus. Suprapubic ultrasonographic examination by radiologist was reported as “a single live fetus in the uterin cavity, and a linear echogenic band at the posterior of the uterin cavity, and a big amount of free fluid in abdomen.” Transvaginal ultrasound revealed that the integrity of the anterior wall of the uterus was impaired, amniotic sac was protruted to the intraabdominal area from the ruptured zone. The patient underwent laparatomy immediately. The previous cesaeran’s scar was ruptured and gestational sac was out of the uterus. Fetal tissues were removed and the scar sutured by two layers. The possibility of an ectopic pregnancy should be considered while examining the first trimester ultrasonography particularly if there is pelvic pain. Moreover rupture of ectopic pregnancy may occur after coitus especially in cesarean scar pregnancy, as the case presented here. For that reason, especially for the patients who underwent medical treatment coitus must be prohibited.
