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Revista Colombiana de Obstetricia y Ginecología
versión impresa ISSN 0034-7434versión On-line ISSN 2463-0225
Resumen
TIPIANI-RODRIGUEZ MD, MSC, Oswaldo; ELIAS-ESTRADA MD, MSC, José Carlos; BOCANEGRA-BECERRA MD, Yuliana Libet y PONCIANO-BIAGGI MD, Miguel Ángel. Treatment of ectopic pregnancy implanted on cesarean scar: cohort study 2018-2022, Lima, Peru. Rev Colomb Obstet Ginecol [online]. 2023, vol.74, n.2, pp.128-135. Epub 30-Jun-2023. ISSN 0034-7434. https://doi.org/10.18597/rcog.3958.
Objectives:
To describe the clinical characteristics and treatment of ectopic pregnancy arising in the cesarean section scar, as well as its complications and obstetric prognosis.
Material and methods:
Retrospective cohort study of pregnant women with the diagnosis of a scar pregnancy in accordance with Maternal-Fetal Medicine Society criteria, seen between January 2018 and March 2022 in two high complexity institutions of the social security system, located in Lima, Peru. Consecutive sampling was used. Baseline sociodemographic and clinical variables were measured, including diagnosis, type of treatment, complications and obstetric prognosis. A descriptive analysis was performed.
Results:
Out of 29,919 deliveries, 17 patients were included. Of these, 41.2 % received medical management and the rest were treated surgically. Successful management with intra-gestational sac methotrexate was performed in two patients with ectopic pregnancy type 2. Four patients required total hysterectomy. Six patients became pregnant after the treatment and 4 completed their pregnancy with healthy mother and neonate pairs.
Conclusions:
Ectopic pregnancy implanted in a cesarean section scar is an infrequent occurrence for which medical and surgical management options are available with apparently good outcomes. Further studies of better methodological quality and random assignment are needed in order to help characterize the safety and effectiveness of the various therapeutic options for women with suspected scar pregnancy.
Palabras clave : Cesarean section; ectopic pregnancy; methotrexate; scar; placenta accreta.