Case Report: Cesarean Scar Ectopic Pregnancy with Placenta Accreta
Authors
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Motahareh Dargahi
- School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.
https://orcid.org/0000-0001-9150-9408
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Niloofar Taheri
- School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.
https://orcid.org/0000-0002-9514-4968
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Sakineh Kolahdozan
- School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.
https://orcid.org/0000-0003-2522-154X
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Zeynab Mohammadi
- School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.
https://orcid.org/0000-0003-4126-382X
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Reza Jafari
- School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran.
https://orcid.org/0000-0001-6362-7933
DOI:
https://doi.org/10.22100/jkh.v17i4.2950Abstract
Introduction: Ectopic pregnancy is the most common cause of maternal mortality, while cesarean scar ectopic is one of the rarest of all ectopic pregnancies. Early diagnosis of this type of pregnancy leads to better control of this situation.
Methods: A 28-year-old 28 weeks’ pregnant woman (G3P1Ab1L1) presented to the emergency department with the complaint of hematuria, labor pain, bleeding, and cervical dilation. The patient was taken to the operating room, considering her past surgical history of cesarean delivery. Due to the recreated placenta and ectopic pregnancy, hysterectomy and Cystorrhaphy were performed.
Results: Cesarean scar ectopic is a type of extrauterine pregnancy that implants around the place of a previous pregnancy scar. This pregnancy may cause severe hemorrhage due to uterine rupture, accreta, and percreta placenta. Bladder invasion by the placenta percreta causes hematuria during pregnancy, so early diagnosis plays a critical role. Ultrasonography is a widely accessible method. As described in this case, a false negative result in ultrasonography causes extensive hemorrhage hysterectomy.
Conclusion: The ectopic pregnancy may occurs in the connective tissue around the site of a previous cesarean scar. This type of pregnancy can cause severe bleeding due to uterine rupture or placenta accreta and placental abruption. Placenta percarta invading the bladder causes hematuria during pregnancy and early diagnosis is very important and the most available diagnostic method is transvaginal ultrasound. A false negative diagnosis may lead to complications such as uncontrollable bleeding and hysterectomy as in this case.
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