Obstet Gynecol Sci.  2016 May;59(3):245-248. 10.5468/ogs.2016.59.3.245.

Concomitant ultrasound-guided intra-gestational sac methotrexate-potassium chloride and systemic methotrexate injection in the recurrent cesarean scar pregnancy

• Lee JH
• Kwon DH
• Ahn KH
• Hong SC
• Kim T

• KMID: 2351793
• DOI: http://doi.org/10.5468/ogs.2016.59.3.245

Abstract

Recurrent ectopic pregnancy of cesarean scar is very rare and its therapeutic management is still not established. We reported the first case of recurrent cesarean scar pregnancy that was successfully treated with concomitant intra-gestational sac methotrexate-potassium chloride injection and systemic methotrexate injection. This case study provides physicians with a safe and effective minimally invasive treatment option for recurrent cesarean scar pregnancy.

Keyword

Beta human chorionic gonadotropin; Cesarean scar pregnancy; Methotrexate; Potassium chloride; Recurrent

MeSH Terms

Cicatrix*
Female
Methotrexate*
Potassium Chloride
Pregnancy*
Pregnancy, Ectopic
Methotrexate
Potassium Chloride

Figure

• 

  Fig. 1 Recurrent cesarean scar pregnancy. (A,B) Ultrasonographic finding of gestational sac with fetal pole in lower segment of the anterior uterine wall. (C) Ultrasonographic finding of gestational remnants in the cesarean scar after the ultrasound-guided intra-gestational sac methotrexate and potassium chloride injection.

• 

  Fig. 2 Changes in serum β-human chorionic gonadotropin concentrations. (A) Changes in serum β-human chorionic gonadotropin concentrations during follow-up at the first cesarean scar pregnancy. (a) Intra-gestational sac potassium chloride (KCL) injection, (b) systemic methotrexate (MTX) injection, (c) intra-gestational sac MTX injection, and (d) systemic MTX injection. (B) Changes in serum β-human chorionic gonadotropin concentrations during follow-up of a recurrent cesarean scar pregnancy. (a) Intra-gestational sac MTX-KCL injection with systemic MTX and (b) systemic MTX injection.

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