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Cesarean scar ectopic pregnancy: a case report of failed combination local and systemic methotrexate management
1Department of Obstetrics and Gynecology, Stony Brook University Medical Center, Stony Brook, NY 11733, USA. erin.e.stevens@gmail.com
Background:
Cesarean scar ectopic pregnancies have been diagnosed with increasing frequency in the last decade. There is no consensus of management for these pregnancies; however, prior reports have suggested best results using either combination methotrexate therapy or surgical excision.
Case:
We present a case of failed systemic and local methotrexate therapy requiring operative management,
Conclusion:
Cesarean scar ectopic pregnancies can have disastrous outcomes, including uterine rupture, massive hemorrhage and maternal death. Although this is the first case to report a failure of the combination therapy, major morbidities did not occur. We believe this is due to our choice of expedient surgical management.