Öz
Sezaryen skar gebelikleri çok nadir görülen ektopik gebelik tiplerinden biridir. Biz bu çalışmada sezaryen skar gebeliği olan 4 olguyu sunmak istedik.
Bu çalışma Ocak 2012-2016 yılları arasında yapılmıştır. Tüm hastalar intramüsküler olarak 50 mg/m2 metotreksat (MTX) ile tedavi edilmişlerdir. Tedavi
sonrasında hastalar serum insan koryonik gonadotropin (ß-hCG) düzeyleri <5 mIU/mL olana kadar izlenmişlerdir. Tüm hastalara ilk trimesterde,
ortalama olarak 7. gebelik haftasında tanı konulmuştur. Tüm hastalar cerrahi gereksinimi olmadan iyileşmişlerdir. ß-hCG değeri <5 mIU/mL olana
kadar geçen ortalama süre 28 (22-35) gündü. Sadece bir hastanın ikinci doz tedaviye gereksinimi oldu. Bu sınırlı olgu serisinden çıkan tecrübemize
göre sistemik metotreksat tedavisi cerrahi tedaviden önce ilk basamak tedavi olarak uygulanabilir.
Anahtar Kelimeler
Etik Beyan
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Destekleyen Kurum
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Proje Numarası
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Teşekkür
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Kaynakça
- 1. Roberts H, Kohlenber C, Lanzarone V, et al. Ectopic pregnancy in lower segment uterine scar. Aust NZJ Obstet Gynaecol. 1998;38:114-116.
- 2. Gao L, Huang Z, Zhang X, et al. Reproductive outcomes following cesarean scar pregnancy - a case series and review of the literature, Eur J Obstet Gynecol Reprod Biol. 2016;200:102-107.
- 3. Ngu SF, Cheung VY. Non-tubal ectopic pregnancy. Int J Gynaecol Obstet. 2011;115:295.
- 4. Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies:etiology, diagnosis, and management. Obstet Gynecol. 2006;107:1373-1381.
- 5. Marchiolé P, Gorlero F, de Caro G, et al. Intramural pregnancy embedded in a previous Cesarean section scar treated conservatively .Ultrasound Obstet Gynecol. 2004;23:307-309.
- 6. Ash A, Smith A, Maxwell D. Caesarean scar pregnancy. BJOG. 2007;114:253-263.
- 7. Vial Y, Petignat P, Hohlfeld P. Pregnancy in a cesarean scar, Ultrasound Obstet Gynecol. 2000;16:592-593.
- 8. Lan W, Hu D, Li Z, et al. Bilateral uterine artery chemoembolization combined with dilation and curettage for treatment of cesarean scar pregnancy: a method for preserving the uterus. J Obstet Gynaecol Res. 2013;1153-1158.
- 9. Kanat-Pektas M1, Bodur S2, Dundar O, et al. Systematic review: What is the best first-line approach for cesarean section ectopic pregnancy? Taiwan J Obstet Gynecol. 2016;55:263-269.
- 10. Wang Q, Peng HL, He L, et al. Reproductive outcomes after previous cesarean scar pregnancy: follow up of 189 women. Taiwan J Obstet Gynecol. 2015;54:5513.
Öz
Caesarean scar pregnancy (CSP) is an uncommon type of ectopic pregnancy. Here, we aim to present management of our four CSP cases. These cases were enrolled between January 2012 and January 2016. All the patients treated with 50 mg/m intramuscular methotrexate (MTX) injection. After treatment, patients were followed until their serum beta human chorionic gonadotropin (β-hCG) levels reached <5 mIU/mL. All the patients were diagnosed at the first trimester, with the average gestational age of 7 weeks. All patients were cured without surgery. The mean time passed until β-hCG reached <5 mIU/mL was 28 (range, 22-35) days. Only one patient needed second dose MTX. Based on this limited number of case-series experience, it seems that systemic MTX should be the first line treatment for CSP instead of surgery.
Anahtar Kelimeler
Etik Beyan
Internally peer-reviewed.
Destekleyen Kurum
-
Proje Numarası
-
Teşekkür
-
Kaynakça
- 1. Roberts H, Kohlenber C, Lanzarone V, et al. Ectopic pregnancy in lower segment uterine scar. Aust NZJ Obstet Gynaecol. 1998;38:114-116.
- 2. Gao L, Huang Z, Zhang X, et al. Reproductive outcomes following cesarean scar pregnancy - a case series and review of the literature, Eur J Obstet Gynecol Reprod Biol. 2016;200:102-107.
- 3. Ngu SF, Cheung VY. Non-tubal ectopic pregnancy. Int J Gynaecol Obstet. 2011;115:295.
- 4. Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies:etiology, diagnosis, and management. Obstet Gynecol. 2006;107:1373-1381.
- 5. Marchiolé P, Gorlero F, de Caro G, et al. Intramural pregnancy embedded in a previous Cesarean section scar treated conservatively .Ultrasound Obstet Gynecol. 2004;23:307-309.
- 6. Ash A, Smith A, Maxwell D. Caesarean scar pregnancy. BJOG. 2007;114:253-263.
- 7. Vial Y, Petignat P, Hohlfeld P. Pregnancy in a cesarean scar, Ultrasound Obstet Gynecol. 2000;16:592-593.
- 8. Lan W, Hu D, Li Z, et al. Bilateral uterine artery chemoembolization combined with dilation and curettage for treatment of cesarean scar pregnancy: a method for preserving the uterus. J Obstet Gynaecol Res. 2013;1153-1158.
- 9. Kanat-Pektas M1, Bodur S2, Dundar O, et al. Systematic review: What is the best first-line approach for cesarean section ectopic pregnancy? Taiwan J Obstet Gynecol. 2016;55:263-269.
- 10. Wang Q, Peng HL, He L, et al. Reproductive outcomes after previous cesarean scar pregnancy: follow up of 189 women. Taiwan J Obstet Gynecol. 2015;54:5513.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Kadın Hastalıkları ve Doğum |
| Bölüm | Makaleler |
| Yazarlar | |
| Proje Numarası | - |
| Yayımlanma Tarihi | 25 Aralık 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 71 Sayı: 3 |
