Successful treatment of cesarean scar pregnancy using laparoscopically assisted local injection of etoposide with transvaginal ultrasound guidance

Objective: To present a case of cesarean scar ectopic pregnancy (CSEP) successfully diagnosed and treated with a laparoscopic local injection of 100 mg etoposide under transvaginal ultrasound assistance. Design: Case report. Setting: University-affiliated teaching hospital. Patient(s): A 37-year-old woman with CSEP. Intervention(s): Local injection of 100 mg etoposide. Main Outcome Measure(s): Serial serum levels of beta-hCG and return of normal menstruation. Result(s): Serial serum beta-hCG levels were 572.2 mIU/mL before operation, 340.7 mIU/mL on the first postoperative day, 28.1 mIU/mL on postoperative day 9, and 5 mIU/mL on postoperative day 17. Menstruation was initiated on postoperative day 45. Conclusion(s): Use of laparoscopic local injection of 100 mg etoposide with transvaginal ultrasound guidance might be an effective method for the management of CSEP. (Fertil Steril (R) 2009;92:1747.e9-e11. (C)2009 by American Society for Reproductive Medicine.)