Chen ZY, Zhou Y, Qian Y, Luo JM, Huang XF, Zhang XM. Management of heterotopic cesarean scar pregnancy with preservation of intrauterine pregnancy: A case report. World J Clin Cases 2021; 9(22): 6428-6434 [PMID: 34435008 DOI: 10.12998/wjcc.v9.i22.6428]
Corresponding Author of This Article
Xiu-Feng Huang, MD, Chief Doctor, Department of Gynecology, Women’s Hospital School of Medicine, Zhejiang University, No. 1 Xueshi Road, Hangzhou 310006, Zhejiang Province, China. huangxiufeng@zju.edu.cn
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Zheng-Yun Chen, Yong Zhou, Xiu-Feng Huang, Xin-Mei Zhang, Department of Gynecology, Women’s Hospital School of Medicine, Zhejiang University, Hangzhou 310006, Zhejiang Province, China
Yue Qian, Jia-Min Luo, Department of Sonography, Women’s Hospital School of Medicine, Zhejiang University, Hangzhou 310006, Zhejiang Province, China
Author contributions: Chen ZY was the main surgeon of this surgery and involved in the concept and design of this manuscript and drafting the article; Zhou Y participated in the surgery and prepared the figures; Qian Y and Luo JM performed ultrasound guidance and prepared the figures; Huang XF and Zhang XM critically revised the manuscript for important intellectual content; all authors contributed toward data analysis and drafting and critically revising the paper, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.
Supported byZhejiang National Science Foundation, No. LGF20H04001; and Zhejiang Bureau of Traditional Chinese Medicine, No. 2017ZA092.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors report no competing interest in this work.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiu-Feng Huang, MD, Chief Doctor, Department of Gynecology, Women’s Hospital School of Medicine, Zhejiang University, No. 1 Xueshi Road, Hangzhou 310006, Zhejiang Province, China. huangxiufeng@zju.edu.cn
Received: April 13, 2021 Peer-review started: April 13, 2021 First decision: May 11, 2021 Revised: May 24, 2021 Accepted: June 1, 2021 Article in press: June 1, 2021 Published online: August 6, 2021
Abstract
BACKGROUND
Heterotopic cesarean scar pregnancy (HCSP) is very rare and has a high risk of massive uterine bleeding. Preservation of concurrent intrauterine pregnancy (IUP) is one of the great challenges in the management of HCSP. No universal treatment protocol has been established when IUP is desired to be preserved.
CASE SUMMARY
We report a case of HCSP at 8+ wk gestation in a 34-year-old woman with stable hemodynamics. A two-step intervention was applied. Selective embryo aspiration was performed first, and surgical removal of ectopic gestational tissue by suction and curettage was performed 2 d later. Both steps were performed under ultrasound guidance. The patient had an uneventful course, and a healthy baby was delivered at 34+6 wk gestation.
CONCLUSION
Selective embryo aspiration followed by suction and curettage was successful in the preservation of IUP in the management of HCSP. This approach is an alternative option for HCSP in the first trimester when the IUP is desired to be preserved.
Core Tip: Preservation of intrauterine pregnancy (IUP) is challenging in the management of heterotopic cesarean scar pregnancy (HCSP). A consensus for the management of HCSP has not been established. We present that selective embryo aspiration followed by suction and curettage is a reliable and minimally invasive approach for the preservation of IUP. It is suggested to be an alternative option for HCSP in the first trimester when the IUP is desired to be preserved.
