Successful selective reduction of a heterotopic cesarean scar pregnancy in the second trimester: a case report and review of the literature

BMC Pregnancy and Childbirth

Case Report

Haiyan Yu¹  Xiaodong Wang¹  Xinghui Liu¹  Fumin Zhao²  Hong Luo³ 

[1] Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China;Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, No.20, 3rd section, South Renmin Road, 610041, Chengdu, Sichuan, China;Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China;Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, No.20, 3rd section, South Renmin Road, 610041, Chengdu, Sichuan, China;Department of Ultrasonic Medicine, West China Second University Hospital, Sichuan University, Chengdu, China;Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, No.20, 3rd section, South Renmin Road, 610041, Chengdu, Sichuan, China;

关键词: Heterotopic cesarean scar pregnancy;    Potassium chloride;    Selective fetal reduction;    Expectant management;   

DOI  :  10.1186/s12884-016-1171-x

 received in 2016-03-23, accepted in 2016-11-17,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundHeterotopic cesarean scar pregnancy is a cesarean scar pregnancy combined with an intrauterine pregnancy that predisposes a woman to life-threatening complications such as uterine rupture and massive bleeding. Preservation of the intrauterine pregnancy in heterotopic cesarean scar pregnancy is a great challenge.Case presentationWe report a case of a 33-year-old woman with heterotopic cesarean scar pregnancy after IVF-embryo transfer (ET). Expectant management was carried out with early diagnosis of heterotopic cesarean scar pregnancy (HCSP), and selective fetal reduction of cesarean scar pregnancy (CSP) was performed by ultrasound-guided intrathoracic injection of potassium chloride (KCl) at 16 + 4 weeks of gestation due to aggravation of CSP. Preservation of the intrauterine pregnancy was successful and a healthy baby was delivered by cesarean section at 37 + 6 weeks of gestation.ConclusionsHeterotopic cesarean scar pregnancy is an extremely rare form of heterotopic pregnancy. Patients should be appropriately counseled regarding the different treatment options available. An ultrasound-guided injection of potassium chloride may constitute a safe, minimally invasive and reliable way to terminate the heterotopic gestation and preserve the intrauterine pregnancy. Intensive management should be performed during the ongoing pregnancy and cesarean section.

【 授权许可】

CC BY   
© The Author(s). 2016