Treatment of heterotopic caesarean scar pregnancy complicated with post termination increase in size of residual mass and morbidly adherent placenta

ABSTRACT We report a case of a secundipara with heterotopic cesarean scar pregnancy (HCSP) treated with potassium chloride injection into the ectopic embryo followed by sac aspiration. The remaining “mass” increased in size threefold and was surrounded by a rich vascular network. An arteriovenous ma...

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Bibliographic Details
Published in:Journal of clinical ultrasound 2018-03, Vol.46 (3), p.227-230
Main Authors: Miyague, Andre Hadyme, Chrisostomo, Adriano Pienaro, Costa, Sergio Luis, Nakatani, Edson Tetsuya, Kondo, William, Gomes, Claudio Corrêa
Format: Article
Language:English
Subjects:
arteriovenous malformation
Bleeding
Case reports
cesarean scar pregnancy
Chlorides
Gestation
heterotopic pregnancy
Hysterectomy
Placenta
Potassium
Potassium chloride
Pregnancy
Ultrasonic imaging
Ultrasound
Viability
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Summary:ABSTRACT We report a case of a secundipara with heterotopic cesarean scar pregnancy (HCSP) treated with potassium chloride injection into the ectopic embryo followed by sac aspiration. The remaining “mass” increased in size threefold and was surrounded by a rich vascular network. An arteriovenous malformation was suspected; however, appropriate treatment was precluded because of the viability of the ectopic gestation. Sonographic examination revealed a morbidly adherent placenta, and attempt to resect the mass laparoscopically was complicated by bleeding that required hysterectomy. This case illustrates a complication of the intervention performed to preserve the intrauterine gestation in case of HCSP. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 46:227–230, 2018
ISSN:0091-2751
1097-0096
DOI:10.1002/jcu.22507