Laparoscopic surgery for ectopic pregnancy within a cesarean scar.

BACKGROUND

Ectopic pregnancy in a previous cesarean section scar is rarely reported, and is very difficult to manage. There are only 12 cases to date that have been successfully managed under laparoscopy.

CASES: Two females were admitted to this Hospital and were suspected to suffer from ectopic pregnancy from a previous cesarean section scar under the impression of Doppler ultrasound. Conservative regimen was first applied to one patient but failed to demonstrate enough efficacy. The beta-human chorionic gonadotropin (beta-HCG) of the other patient was extremely high, therefore conservative treatment was not considered. Then laparoscopic surgery was performed for the two patients and not only confirmed the diagnosis, but also successfully removed the ectopic gestational products. Surgery under laparoscopy was uneventful. Total surgical time was 80 minutes, blood loss was only about 100 ml, and blood transfusion was not necessary.

CONCLUSION

It seems that for a skilled surgeon, laparoscopy may be a sound and reasonable technique to diagnose and resect ectopic pregnancy within a cesarean scar.