Cesarean scar ectopic pregnancy: a case report of failed combination local and systemic methotrexate management requiring surgical intervention
Stevens, E.E.; Ogburn, P.
Journal of Reproductive Medicine 56(7-8): 356-358
2011
ISSN/ISBN: 0024-7758 PMID: 21838169 Document Number: 652930
Cesarean scar ectopic pregnancies have been diagnosed with increasing frequency in the last decade. There is no consensus of management for these pregnancies; however, prior reports have suggested best results using either combination methotrexate therapy or surgical excision. We present a case of failed systemic and local methotrexate therapy requiring operative management, Cesarean scar ectopic pregnancies can have disastrous outcomes, including uterine rupture, massive hemorrhage and maternal death. Although this is the first case to report a failure of the combination therapy, major morbidities did not occur. We believe this is due to our choice of expedient surgical management.