Cesarean scar pregnancie
Majdouline Boujoual, Driss Rahali Moussaoui
The Pan African Medical Journal. 2018;30:228. doi:10.11604/pamj.2018.30.228.14384

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Cesarean scar pregnancie

Cite this: The Pan African Medical Journal. 2018;30:228. doi:10.11604/pamj.2018.30.228.14384

Received: 12/11/2017 - Accepted: 15/01/2018 - Published: 26/07/2018

Key words: Pregnancy, Cesarean scar, echography

© Majdouline Boujoual et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/30/228/full

Corresponding author: Majdouline Boujoual, Department of Obstetrics and Gynecology, Military Training Hospital Mohammed V, Rabat, Morocco (pr.majdouline@hotmail.fr)


Cesarean scar pregnancie

Majdouline Boujoual1,&, Driss Rahali Moussaoui1

 

1Department of Obstetrics and Gynecology, Military Training Hospital Mohammed V, Rabat, Morocco

 

 

&Corresponding author
Majdouline Boujoual, Department of Obstetrics and Gynecology, Military Training Hospital Mohammed V, Rabat, Morocco

 

 

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A 35 years old woman presented at 8-week gestation for her first prenatal visit. She had no complaints at the time. While her past obstetrical history showed two prior cesarean sections. Transvaginal ultrasound was performed showing fortuitously a cesarean scar ectopic pregnancy with a gestational sac implanted in the myometrium between the bladder and the anterior wall of the uterus (A) and associated with a periovulatory hyper-vascularization in color doppler (B). This aspect was confirmed in 3D Ultrasound which showed a gestational sac bulging through the anterior wall of the uterus into the bladder with diminished myometrial layer between the bladder and the sac (C). The outcome was favorable after conservative surgical treatment by laparotomy associated with a triple preventive ligation because of the high risk of bleeding. Cesarean scar pregnancy is so a rare iatrogenic complication of cesarean section; however, her incidence is actually growing due to the increase in cesarean section rates. The diagnosis is usually made via ultrasound showing an empty uterine cavity and cervical canal, a gestational sac located anteriorly at the isthmus, and evidence of a functional trophoblastic/placental circulation on color Doppler. Early diagnosis is crucial to avoid severe vital and functional complications such as hemorrhage, early uterine rupture and hysterectomy, so its recognition is important to keep fertility of young woman.

 

Figure 1: A) transvaginal echography in sagittal section showing a gestational sac implanted in the myometrium between the bladder and the anterior wall of the uterus with emptiness of the uterus and cervical canal; B) doppler ultrasound with color mode showing a periovulatory hyper-vascularization; C) ultrasound with 3D mode objectifying a gestational sac bulging through the anterior wall of the uterus into the bladder with diminished myometrial layer between the bladder and the sac

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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Keywords

Pregnancy
Cesarean scar
Echography

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