4.6 Editorial Material

A laparoscopic approach to cesarean scar ectopic pregnancy

Journal

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Volume 226, Issue 3, Pages 417-419

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2021.11.021

Keywords

cesarean scar ectopic pregnancy; laparoscopy; minimally invasive; surgery; video

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Cesarean scar pregnancies pose significant risks and complications, requiring appropriate management. This article presents a combined medical and surgical approach that effectively terminated and excised a 12-week cesarean scar pregnancy, demonstrating a minimally invasive outpatient procedure and preserving future fertility.
Cesarean scar pregnancies confer serious risk and severe morbidity. Appropriate management is the key to preventing complications. Although expectant management is usually contraindicated, the ideal combination of medical or surgical treatments is unclear and must be tailored to the patient's preferences and stability, provider skill, and the available resources. In this article, we present a combined medical and surgical approach that was successfully employed for the termination and excision of a cesarean scar pregnancy at 12 weeks' gestation in a patient desiring uterine preservation. A video is included, demonstrating the surgical steps of a laparoscopic approach used to safely resect the pregnancy and cesarean delivery scar with minimal blood loss. The management technique described can be utilized to effectively resolve cesarean scar pregnancy, to possibly decrease the risk of recurrence, and preserve future fertility with a minimally invasive outpatient surgery.

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