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Ectopic pregnancy in a cesarean section scar

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1 Ectopic pregnancy in a cesarean section scar
An-Jen Chiang, M.D., Victor La, B.A., Chen-Pin Chou, M.D., Peng-Hui Wang, M.D., Ph.D., Ken-Jen Yu, M.D., Ph.D.  Fertility and Sterility  Volume 95, Issue 7, Pages (June 2011) DOI: /j.fertnstert Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions

2 Figure 1 A gestational sac with a positive fetal heartbeat (crown–rump length: 17.9 mm) located in the thin lower-anterior wall of the uterus behind a previous cesarean section scar (arrow), as demonstrated via abdominal sonography. Fertility and Sterility  , DOI: ( /j.fertnstert ) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions

3 Figure 2 Cesarean scar pregnancy (CSP) in a 42-year-old woman at 8+3 weeks’ gestation. The sagittal T2-weighted magnetic resonance image shows a gestational sac-like structure within the lower segment of the anterior uterine wall, corresponding to the caesarean scar (long arrow). The markedly thinned myometrium between the gestational sac-like structure and the urinary bladder was indicative of a CSP. The abdominal CS scar (short arrow) also is shown. Fertility and Sterility  , DOI: ( /j.fertnstert ) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions

4 Figure 3 (A) The patient received hysteroscopy and sonar guided dilation and curettage to remove remaining any pathologically proven gestational tissue (black arrow). Her β-human chorionic gonadotropin (β-hCG) levels were monitored weekly and vaginal ultrasound was performed biweekly until her β-hCG levels returned to normal levels. (B) Histologic examination showing a cluster of trophoblast cells (short arrow) and uterine myometrial muscle bundles (long arrow) (stain: hematoxylin-eosin; magnification: ×200). Fertility and Sterility  , DOI: ( /j.fertnstert ) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions


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