Hysteroscopic Surgery of Ectopic Pregnancy in the Cesarean Section Scar

Study ObjectiveTo evaluate the effect of hysteroscopy in the treatment of caesarean section scar pregnancy.DesignRetrospective review.ParticipantsThirty-nine patients with cesarean scar pregnancy.InterventionsBetween January 2006 and June 2008, 39 patients with caesarean section scar pregnancy underwent hysteroscopic removal of conceptive tissues in our department. Their medical records were reviewed retrospectively.Measurements and Main ResultsThe diagnosis was confirmed by serum human chorionic gonadotropic concentration and at ultrasonographic or magnetic resonance imaging. All patients underwent hysteroscopic removal of conceptive tissues under ultrasonographic guidance. Before surgery, 36 patients received 25 mg of oral mifepristone, 25 mg, twice a day for 3 days, and 3 patients received an injection of methotrexate salt, 50 mg, and underwent preoperative bilateral uterine artery embolization. Results were reported as good in 37 patients; only 2 patients required additional surgery.ConclusionHysteroscopic removal of conceptive tissues implanted in a cesarean section scar seems to be a feasible and safe procedure that might be considered as a treatment option.