Type 2 Cesarean Scar Pregnancy Successfully Treated via Hysteroscopy-Assisted Laparoscopy.

STUDY

OBJECTIVE

To evaluate the efficacy of hysteroscopy-assisted laparoscopy as a treatment strategy for type 2 cesarean scar pregnancy at gestational age >8 weeks.

DESIGN

Retrospective case series (Canadian Task Force classification II-3).

SETTING

A tertiary hospital.

PATIENTS: Eight women with type 2 cesarean scar pregnancy at a gestational age >8 weeks.

INTERVENTIONS: All patients underwent hysteroscopy-assisted laparoscopic resection and isthmus repair of cesarean scar pregnancy.

MEASUREMENTS AND MAIN

RESULTS

All patients underwent removal of the cesarean scar pregnancy and complete repair of the uterine scar defect. The median operative time was 123.0 minutes (range, 100-168 minutes), median blood loss was 65.0 mL (range, 20-100 mL), and median length of hospital stay was 9.1 days (range, 8-12 days). There were no adverse reactions. The mean time to serum β-human chorionic gonadotropin (β-HCG) resolution was 22.9 days (range, 14-30 days), and menstruation resumed after 9 to 15 days with serum β-HCG returning to nondetectable levels. There was no recurrence of cesarean scar pregnancy at long-term follow-up.

CONCLUSION

Hysteroscopy-assisted laparoscopy may be an effective treatment for patients with type 2 cesarean scar pregnancy at gestational age >8 weeks.