Page 65 - World Journal of Laparoscopic Surgery

Laparoscopic Management of Cesarean Scar Pregnancy

Figs 3A to D: Case 2: Intraoperative images illustrating scar ectopic and laparoscopic repair

Figs 4A to D: Case 3: Ultrasound and intraoperative images depicting scar ectopic and laparoscopic repair

live intrauterine gestation with gestational age corresponding to • Suction evacuation and laparoscopic tubal sterilization was planned.
10 weeks 1 day. She had taken MTP pills 2 weeks ago following On suction, excessive vaginal bleeding around 250 mL was noted.
which she had vaginal bleeding for 3 days. She had childbirth Thus, uterine perforation or scar ectopic pregnancy was suspected
previously 7 and 4 years ago by full-term cesarean sections. and diagnostic laparoscopy was performed. A vascular mass of
• On examination, the vitals were within normal limits. Abdomen around 4 cm × 5 cm was found at the site of the previous C-section
was soft, non-tender. On speculum examination, closed cervical scar on left side suggestive of scar ectopic and adnexa were normal
OS was noted. On bimanual examination, cervix was firm, uterus (Fig. 3). Laparoscopic scar excision and suturing and bilateral tubal
was anteverted and bilateral fornices were free and non-tender. sterilization was also performed. Tissue was subjected to HPE and
Relevant investigations were done; hemoglobin was 9 gm/dLand diagnosis of C-section scar ectopic pregnancy was confirmed.
β-hCG level was 15820 IU/L. Repeat β-hCG level on postoperative day 3 was 821 IU/L.

World Journal of Laparoscopic Surgery, Volume 15 Issue 3 (September–December 2022) 251