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Conservative medical treatment of ectopic pregnancy in a previous cesarean section scar Daniela Flores-Osornio1, Adalberto Castilla-Zenteno2 y Enrique
Conservative medical treatment of ectopic pregnancy in a previous cesarean section scar Daniela Flores-Osornio1, Adalberto Castilla-Zenteno2 y Enrique
Daniela Flores-Osornio 1, Adalberto Castilla-Zenteno 2, Enrique Martínez-Villafaña 3
1 Servicio de Ginecología, Hospital de la Mujer Puebla, Puebla, Pue., México; 2 Servicio de Medicina Materno Fetal. Hospital de la Mujer Puebla, Puebla, Pue., México; 3 Servicio de Ginecología, Hospital General IMSS Bienestar Cuajimalpa, Ciudad de México, México
*Correspondence: Enrique Martínez-Villafaña. Email: enriquemv93@gmail.com
Abstract
Ectopic pregnancy in a previous cesarean section scar is the embryonic implantation in the myometrium of a previous cesarean section scar. The clinical case of a 38-year-old patient is presented, with an ultrasonographic report of a 6.6-week embryo located in the anterior wall of the uterine isthmus; quantification of hCG-β in 6,402 mIU. Conservative management was chosen through ultrasound-guided transcervical gestational sac puncture, administering intrasaccular methotrexate 1 mg/kg, and a single intravenous dose of 50 mg. The hormone became negative six weeks after the procedure. The use of combined systemic and local methotrexate is a safe option, with a high effectiveness rate.
Keywords: Cesarean section. Ectopic pregnancy. Conservative treatment. Methotrexate.
