Main Article Content
Abstract
Résumé :
Nous rapportons le cas d’une grossesse ectopique sur cicatrice de césarienne diagnostiquée à 5 semaines d’aménorrhée chez une patiente de 36 ans, 5ème geste et 3ème pare. Grâce à l’échographie endovaginale le diagnostic a été précoce. La patiente a eu un traitement conservateur avec succès. Nous discutons le diagnostic et le traitement pour contribuer à améliorer la prise en charge.
Mots clés : grossesse ectopique, cicatrice de césarienne, embolisation utérine.
Summary:
We report the case of a cesarean scar ectopic pregnancy, diagnosed at 5 weeks of gestation, in a 36 years old patient, 5 pregnacies and 3 delivries. The diagnosis was made early using a transvaginal ultrasound probe. The patient was treated conservatively with success. We then discuss diagnosis and treatment to help improve management.
Key words : ectopic pregnancy, caesarean scar, uterine embolization.
Article Details
References
- Jurkovic D, Hillaby K, Woelfer B, Lawrence A, Salim R , Elson CJ. First-trimester diagnosis of pregnancy implanted into the lower uterine segment cesarean section scar. Ultrasound obstet gynecol. 2003;21:220-27.
- Seow KM, Huang LW, Lin YH, Yan-Sheng Lin M, Tsai YL, Hwang JL. Cesarean scar pregnancy: issues in management. Ultrasound obstet gynecol. 2004;23:247-53.
- Riethmuller D, Courtois L, Maillet, Schaal J-P. Prise en charge de la grossesse extra-utérine : les autres ectopies (cervicales et abdominales). J Gynecol Obstet Biol Reprod. 2003;32:101-08.
- Maheut L, Seconda S, Bauville E, Levêque J. Grossesse sur cicatrice de césarienne : un cas clinique de traitement conservateur. J Gynecol Obstet Biol Reprod. 2010;39:254-58.
- Damarey I, Durant-Reville M, Robert Y et Leroy JL. Fait clinique diagnostic d'une grossesse ectopique sur cicatrice de césarienne. J Radiol. 1999;80:44
- Chetty M, Elson J. Treating non-tubal ectopic pregnancy. Best Pract Res Clin Obstet Gynaecol. 2009;23:529-38.
- Jannet D, Jerbi M. Utérus cicatriciel. In: cabrol D, Pons J-C, Goffinet F, editors. Traité d’obstétrique. Paris: Flammarion Médecine-Sciences ;2003.p.337-45.
- Miller D A, Chollet JA, Murphy Goodwin T. Clinical risk factors for placenta praevia - placenta accreta. Am J Obstet Gynecol. 1997;177:210-14.
- Maymon R, Halperin R, Mendlovic S, Schneider D, Herman A. Ectopic pregnancies in a caesarean scar: review of the medical approach to an iatrogenic complication. Hum Reprod Update. 2004;10:515–23.
- Maymon R, Halperin R, Mendlovic S, Schneider D,Vaknin Z, Herman A et al. Ectopic pregnancies in cesarean section scars: the 8-years experience of one medical center. Hum Reprod. 2004;19:278-84.
- Salomon LJ., Fernandez H, Chauveaud A, Doumerc S, Frydman R. Successful management of a heterotopic Caesarean scar pregnancy: potassium chloride injection with preservation of the intrauterine gestation: Case report. Hum Reprod. 2003;18:189-91.
- Uszynski W, uszynski M. placenta accreta: epidemiology, molecular mechanism(hypothesis and some clinical remarks. Ginekol pol.2004;75-8. Abstract Pubmed
- Usta IM, Hobeika EM, Abu Musa AA, Gabriel GE, Nassar AH. Placenta previa-accreta:risk factors and complications. Am J Obstet Gynecol. 2005;193:1045-9.
- Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management. Obstet Gynecol. 2006;107:1373-81. (Abstract Pub Med)
- Moschos E, Twickler DM. First trimester diagnosis of cesarean scar ectopic pregnancy. J clin ultrasound. 2008;36:504-11.
- Vial Y, Petignat P, Hohlfeld P. Pregnancy in a cesarean scar. Ultrasound Obstet Gynecol. 2000;16:592-3.
- Takeda A, Koyama K, Imoto S, Mori M, Nakano T, Nakamura H. Diagnostic multimodal imaging and therapeutic transcatheter arterial chemoembolization for conservative management of hemorrhagic cesarean scar pregnancy. Eur J Obstet Gynecol Reprod Biol. In press.
- Deans R, Abbott J. Hysteroscopic management of cesarean scar ectopic pregnancy. Fertility and sterility, 2010.93(6):1735-40.
References
Jurkovic D, Hillaby K, Woelfer B, Lawrence A, Salim R , Elson CJ. First-trimester diagnosis of pregnancy implanted into the lower uterine segment cesarean section scar. Ultrasound obstet gynecol. 2003;21:220-27.
Seow KM, Huang LW, Lin YH, Yan-Sheng Lin M, Tsai YL, Hwang JL. Cesarean scar pregnancy: issues in management. Ultrasound obstet gynecol. 2004;23:247-53.
Riethmuller D, Courtois L, Maillet, Schaal J-P. Prise en charge de la grossesse extra-utérine : les autres ectopies (cervicales et abdominales). J Gynecol Obstet Biol Reprod. 2003;32:101-08.
Maheut L, Seconda S, Bauville E, Levêque J. Grossesse sur cicatrice de césarienne : un cas clinique de traitement conservateur. J Gynecol Obstet Biol Reprod. 2010;39:254-58.
Damarey I, Durant-Reville M, Robert Y et Leroy JL. Fait clinique diagnostic d'une grossesse ectopique sur cicatrice de césarienne. J Radiol. 1999;80:44
Chetty M, Elson J. Treating non-tubal ectopic pregnancy. Best Pract Res Clin Obstet Gynaecol. 2009;23:529-38.
Jannet D, Jerbi M. Utérus cicatriciel. In: cabrol D, Pons J-C, Goffinet F, editors. Traité d’obstétrique. Paris: Flammarion Médecine-Sciences ;2003.p.337-45.
Miller D A, Chollet JA, Murphy Goodwin T. Clinical risk factors for placenta praevia - placenta accreta. Am J Obstet Gynecol. 1997;177:210-14.
Maymon R, Halperin R, Mendlovic S, Schneider D, Herman A. Ectopic pregnancies in a caesarean scar: review of the medical approach to an iatrogenic complication. Hum Reprod Update. 2004;10:515–23.
Maymon R, Halperin R, Mendlovic S, Schneider D,Vaknin Z, Herman A et al. Ectopic pregnancies in cesarean section scars: the 8-years experience of one medical center. Hum Reprod. 2004;19:278-84.
Salomon LJ., Fernandez H, Chauveaud A, Doumerc S, Frydman R. Successful management of a heterotopic Caesarean scar pregnancy: potassium chloride injection with preservation of the intrauterine gestation: Case report. Hum Reprod. 2003;18:189-91.
Uszynski W, uszynski M. placenta accreta: epidemiology, molecular mechanism(hypothesis and some clinical remarks. Ginekol pol.2004;75-8. Abstract Pubmed
Usta IM, Hobeika EM, Abu Musa AA, Gabriel GE, Nassar AH. Placenta previa-accreta:risk factors and complications. Am J Obstet Gynecol. 2005;193:1045-9.
Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management. Obstet Gynecol. 2006;107:1373-81. (Abstract Pub Med)
Moschos E, Twickler DM. First trimester diagnosis of cesarean scar ectopic pregnancy. J clin ultrasound. 2008;36:504-11.
Vial Y, Petignat P, Hohlfeld P. Pregnancy in a cesarean scar. Ultrasound Obstet Gynecol. 2000;16:592-3.
Takeda A, Koyama K, Imoto S, Mori M, Nakano T, Nakamura H. Diagnostic multimodal imaging and therapeutic transcatheter arterial chemoembolization for conservative management of hemorrhagic cesarean scar pregnancy. Eur J Obstet Gynecol Reprod Biol. In press.
Deans R, Abbott J. Hysteroscopic management of cesarean scar ectopic pregnancy. Fertility and sterility, 2010.93(6):1735-40.