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academies
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 formof ectopicpregnancy. Subsequentpregnancy following
CSP is usually associatedwith complications suchasmiscarriage,
placentapreviaor accreta, life threateninghaemorrhage leading
tohysterectomy anduterine rupture threatening lives ofmother
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, bloodwas 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, UK. She has worked as Ob/Gyn Resident with
wide knowledge in the field of obstetrics and gynecology. Her area of research includes
maternal fetal medicine and obstetrics.
e:
suchana.dhital@gmail.comSuchana Dhital et al.
, Res Rep Gynaecol Obstet, Volume 3
DOI: 10.4066/2591-7366-C1-002