Non-developing pregnancy in the uterine scar after caesarean section: diagnostic difficulties
- Authors: Kurtser M.A.1, Breslav I.Y.2, Kolotilova M.L.3, Barykina O.P.2, Scriabin N.V.2, Kurbatskaya O.N.4
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Affiliations:
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
- MD GROUP Clinical Hospital, MD PROJECT 2000
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
- Lapino Clinical Hospital
- Issue: No 2 (2023)
- Pages: 160-164
- Section: Clinical Notes
- URL: https://journals.eco-vector.com/0300-9092/article/view/340804
- DOI: https://doi.org/10.18565/aig.2022.214
- ID: 340804
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Abstract
Background: The steady increase in the number of patients with a history of even one caesarean section leads to a rise in the frequency of such form of ectopic pregnancy, as pregnancy in the scar. The choice of the optimal organ-sparing treatment option for this category of patients depends on timely diagnosis. The formation of retrochorial hematoma that accompanies non-developing pregnancy in the scar in the early stages significantly complicates the diagnosis.
Case report: The paper describes a clinical case of a reproductive-aged patient, in whom a long episode of menometrorrhagia ended with the formation of a round mass up to 8 cm in diameter in the area of the scar after cesarean section at the uterine isthmus. Erroneously diagnosed incomplete abortion during uterine pregnancy and uterine fibroids served as a reason for uterine curettage complicated by massive blood loss. The final diagnosis was established after pathological mass excision and metroplasty.
Conclusion: A pathological uterine mass localized in the scar area after cesarean section, which is suddenly detected during abnormal uterine bleeding, requires the exclusion of pregnancy in this area. Correct diagnosis of non-developing pregnancy in the scar is the key to successful organ-sparing surgery.
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About the authors
Mark A. Kurtser
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Email: m.kurtser@mcclinics.ru
ORCID iD: 0000-0003-0175-1968
MD, PhD, Professor, Member of the Russian Academy of Sciences, Head of Department of Obstetrics and Gynecology, Pediatric Faculty
Russian Federation, MoscowIrina Yu. Breslav
MD GROUP Clinical Hospital, MD PROJECT 2000
Author for correspondence.
Email: irina_breslav@mail.ru
ORCID iD: 0000-0002-0245-4968
MD, PhD, Head of the Department of Pathology of Pregnancy
Russian Federation, MoscowMarina L. Kolotilova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Email: Kolotilovaml@hotmail.com
ORCID iD: 0000-0001-7270-8671
MD, PhD, Professor at Human Pathology Department, Institute of Biodesign and Modeling of Complex Systems
Russian Federation, MoscowOlga P. Barykina
MD GROUP Clinical Hospital, MD PROJECT 2000
Email: medslovar@mail.ru
Head of the Department of Pathology, Pathologist
Russian Federation, MoscowNikolay V. Scriabin
MD GROUP Clinical Hospital, MD PROJECT 2000
Email: hranitelkr@mail.ru
ORCID iD: 0000-0001-8247-7563
Pathologist at the Department of Pathology
Russian Federation, MoscowOlga N. Kurbatskaya
Lapino Clinical Hospital
Email: kuron682@gmail.com
MD, Head of the Department of Pathology of Pregnancy
Russian Federation, Moscow RegionReferences
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