書誌事項
- タイトル別名
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- A case of hysteroscopic treatment for cesarean scar pregnancy
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Objective: A case of cesarean scar pregnancy (CSP) treated by a combination of systemic methotrexate (MTX) administration, selective uterine artery embolization (UAE), and hysteroscopic surgery is reported.<BR>Case: A 37-year-old woman, with a history of two previous cesarean sections, presented with suspicion of a cervical pregnancy at 5 weeks' gestation. A diagnosis of CSP was made by ultrasonography when a gestational sac and viable embryo (without heart movement) were detected near the right cesarean scar. The findings were confirmed by magnetic resonance imaging. In addition, three-dimensional CT angiography showed that the gestational sac was perfused by only the right uterine artery. At first, single dose MTX (50 mg/body intramuscularly) was given. However, it failed, and serum hCG levels increased from 21995 mIU/ml to 38831 mIU/ml, and embryonic cardiac activity was detected. Therefore, the regimen was changed to a fixed multidose MTX regimen, which seemed effective because the serum hCG levels decreased gradually, and the fetal heartbeat was lost. At 9 weeks' gestation, the tissues of conception were removed by hysteroscopic surgery three days after selective right UAE. There were no complications such as heavy bleeding or uterine perforation.<BR>Conclusion: When removing the gestational sac in CSP, hemorrhage may often be difficult to stop. However, there is no consensus about the optimal method for treating CSP. We consider that a combination of systemic MTX administration, selective UAE, and hysteroscopic surgery is a safe and useful treatment for CSP.
収録刊行物
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- 日本産科婦人科内視鏡学会雑誌
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日本産科婦人科内視鏡学会雑誌 28 (1), 336-341, 2012
日本産科婦人科内視鏡学会
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詳細情報 詳細情報について
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- CRID
- 1390282680321146624
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- NII論文ID
- 10031121785
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- NII書誌ID
- AN10068110
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- ISSN
- 18845746
- 18849938
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- Crossref
- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可