Ruptured caesarean scar ectopic pregnancy: a diagnostic dilemma in a resource-limited setting

BMC Research Notes
Atem Bethel AjongPhilip Nana Njotang

Abstract

Caesarean scar pregnancy (CSP) remains a very rare form of ectopic pregnancy associated with serious life threatening obstetric complications and even death in case of late diagnosis and treatment. We report a case of a ruptured caesarean scar pregnancy in a 29 year-old gravida 5, para 3 with a past obstetric history of two consecutive caesarean sections done 9 and 5 years ago respectively. The patient presented with intermittent lower abdominal pains on a 20 weeks gestation associated with mild epigastralgia and 2 previous episodes of mild pervaginal bleeding (2 and 1 months ago respectively before consultation) managed with injectable progesterone. Her evolution 4 h later was marked by an increase in the intensity of the abdominal pain, an unmeasurable blood pressure and a feeble pulse. Immediate paracentesis revealed 10 cc of fresh non coagulating blood. The diagnosis of ruptured ectopic pregnancy with abundant hemoperitoneum was considered and an emergency laparotomy with fluid and blood resuscitation was carried out. A midline laparotomy revealed a ruptured caesarean scar ectopic pregnancy with an abundant hemoperitoneum. Careful resection of the placenta and repair of the ruptured isthmic region of the uterus was carried ...Continue Reading

References

Apr 1, 2003·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·D JurkovicC J Elson
Feb 23, 2007·BJOG : an International Journal of Obstetrics and Gynaecology·A AshD Maxwell
Sep 29, 2009·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Camille Michener, Jan E Dickinson
Dec 10, 2015·Radiology Case Reports·Rajarshi AichAjita Nawale
Jun 21, 2017·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·Aderemi Olaoluwa AlaladeFunlayo Odejinmi

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hysterectomy

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