Non-developing pregnancy in the uterine scar after caesarean section: diagnostic difficulties
- 作者: 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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隶属关系:
- 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
- 期: 编号 2 (2023)
- 页面: 160-164
- 栏目: 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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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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作者简介
Mark 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
俄罗斯联邦, MoscowIrina Breslav
MD GROUP Clinical Hospital, MD PROJECT 2000
编辑信件的主要联系方式.
Email: irina_breslav@mail.ru
ORCID iD: 0000-0002-0245-4968
MD, PhD, Head of the Department of Pathology of Pregnancy
俄罗斯联邦, MoscowMarina 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
俄罗斯联邦, MoscowOlga Barykina
MD GROUP Clinical Hospital, MD PROJECT 2000
Email: medslovar@mail.ru
Head of the Department of Pathology, Pathologist
俄罗斯联邦, MoscowNikolay Scriabin
MD GROUP Clinical Hospital, MD PROJECT 2000
Email: hranitelkr@mail.ru
ORCID iD: 0000-0001-8247-7563
Pathologist at the Department of Pathology
俄罗斯联邦, MoscowOlga Kurbatskaya
Lapino Clinical Hospital
Email: kuron682@gmail.com
MD, Head of the Department of Pathology of Pregnancy
俄罗斯联邦, Moscow Region参考
- Ministry of Health of Russian Federation. Clinical guidelines. Ectopic (ectopic) pregnancy, 2021. (in Russian).
- Baranovskaya E.I. Ectopic ovum and heterotopic pregnancy. Topical issues of obstetrics and gynecology in Belarus. 2018; 4: 9-11. (in Russian).
- M.E. Shchepelev, T.V. Deripasko, A.A. Sidorova, E.G. Drandrova, E.V. Moskvichev, T.Yu. Clinical case of non-developing pregnancy in the uterine scar after caesarean section. Acta Medica Eurasica. 2021; 3: 26-34. (in Russian). https://dx.doi.org/10.47026/ 2413-4864-2021-3-26-34.
- Buyanova S.N., Shchukina N.A., Chechneva M.A., Puchkova N.V., Zemskova N.Yu., Torobaeva M.T. Pregnancy in the scar after caesarean section: the possibility of surgical correction. Russian Bulletin of the Obstetrician-Gynecologist. 2020; 20(6): 65-70. (in Russian). https://dx.doi.org/10.17116/rosakush20202006165.
- Zakharov I.S., Elgina S.I., Mozes V.G., Rudaeva E.V., Pachgin I.V., Rybnikov S.V. Ectopic pregnancy in the scar after caesarean section. Mother and Child in Kuzbass. 2020; 4: 88-91. (in Russian). https://dx.doi.org/10.24411/2686-7338-2020-10055.
- Timor-Tritsch I.E., Monteagudo A. Unforeseen consequences of the increasing rate of cesarean deliveres: early placenta accrete and cesarean scar pregnancy. A review. Am. J. Obstet. Gynecol. 2012; 207(1): 14-29. https://dx.doi.org/ 10.1016/j.ajog.2012.03.007.
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