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- Title
Ciąże w bliźnie po cięciu cesarskim - różne metody postępowania w Klinice Endokrynologii Ginekologicznej i Ginekologii Szpitala Uniwersyteckiego.
- Authors
DOROSZEWSKA, Katarzyna; HORBACZEWSKA, Anna; KOMENDA, Justyna; KŁOSOWICZ, Estera; ROBERT, Jach
- Abstract
Introduction: Ectopic pregnancy constitutes 1% of all pregnancies, most frequently it localises in oviduct (92% cases). Recently, due to the rising amount of cesarean sections, new location of ectopic pregnancy has been observed - cesarean scar pregnancy (CSP).Cesarean scar pregnancy is an iatrogenic disease and a life threatening condition which frequency will rise systematically. Because of possible serious complications, CSP should be swiftly diagnosed and treated. Aim: The purpose of this study was to demonstrate different methods of CSP treatment performed between 2014-2017 in the Clinic of Endocrynological Gynecology Jagiellonian University Medical College in Cracow. Material and Methods: The studied group consisted of 20 patient with CSP. Results: Patients, who were admitted to the Department, were hemodynamically stable. The average level of beta-HCG on admission was 42527.15 mIU/ml. In the group of 17 patients, embryo with present heart rate was found. Only one case showed the embryo without heart rate and the rest of the patients had a gestational sack without echo of the embryo. 14 patients were treated conservativly: 5 ml of 10% KCl or 2 ml of 15% KCl and 50 mg of methotrexate were injected into the gestational sack. Methotrexate 100 mg was given systemically as a continuation of the treatment. Rest of the patients required surgery intervention - laparotomy or hysteroscopy. In all cases after treatment a satisfactory decrease in beta-HCG level was observed. Summary: Definitive algorithm of CSP treatment is still not established. Pharmacological and operative methods are approved but expectant observation is considered unsafe due to possible risk of complications for the patient. Quick diagnosis, as well as fast treatment is a must in all CSP cases.
- Subjects
ECTOPIC pregnancy; CESAREAN section; TREATMENT effectiveness; IATROGENIC diseases; UNIWERSYTET Jagiellonski
- Publication
Review of Medicine / Przeglad Lekarski, 2018, Vol 75, Issue 9, p448
- ISSN
0033-2240
- Publication type
Article