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February 28-March 01, 2019 | Paris, France
Palliative Care, Obstetrics and Gynecology
Stroke and Clinical Trials
International Conference on
Joint Event on
International Conference on
&
Journal of Research and Reports in Gynecology and Obstetrics | Volume: 3
Successful vaginal delivery after surgical evacuation of caesarean scar ectopic pregnancy: A case report
Suchana Dhital, Beena Subba
and
Abha Govind
North Middlesex University Hospital, UK
T
his case study aims to review timing and mode of
delivery in women in subsequent pregnancy following
caesarean scar ectopic pregnancy. Caesarean Scar Ectopic
Pregnancy (CSP) is a rare form of ectopic pregnancy.
Subsequent pregnancy following CSP is usually associated
with complications such as miscarriage, placenta previa
or accreta, life threatening haemorrhage leading to
hysterectomy and uterine rupture threatening lives of
mother and fetus. Given the low incidence of CSP, even
lower rate of successful conception rate following CSP, lack
of consensus on treatment modalities of CSP and subsequent
pregnancy and risk of complications, delivery of women with
subsequent pregnancies following CSP is usually carried out
by caesarean section at term. We report on a case describing
uncomplicated pregnancy course and successful vaginal
delivery of a woman who had had caesarean scar ectopic
pregnancy previously.
The case of 38-year-old, Gravida 7 P2+4, who was diagnosed
with a CSP in her 5th pregnancy and managed by evacuation
of caesarean scar ectopic pregnancy, was followed up from
7+6 weeks of pregnancy till postpartum period. She was
induced with dinoprostone at 37+3weeks of pregnancy.
Labour was conducted under epidural analgesia, blood was
readily available and the fetus was continuously monitored
throughout labour. Healthy baby of birth weight 3.19kg
was delivered without complications with second degree
perineal tear. Obstetric management was largely based
upon current literature and professional experience as
there are not specific guidelines for the management in
subsequent pregnancy after CSP. Although, subsequent
pregnancy following caesarean scar pregnancy is associated
with significant morbidity at all stages of pregnancy, hence,
is recommended to deliver women by caesarean section at
term, this case demonstrates that vaginal delivery can be
an option with careful case selection, close monitoring and
informed consent from patient.
Speaker Biography
Suchana Dhital is a Speciality Registrar in Department of Obstetrics and Gynaecology at
North Middlesex University Hospital, London.
e:
suchana.dhital@gmail.comSuchana Dhital et al.
, Res Rep Gynaecol Obstet, Volume 3
DOI: 10.4066/2591-7366-C1-003