February 15th, 2019

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Cesarean Scar Pregnancy: A Novel Approach to Management: A Case Report
Authors:  Amber M. Klimczak, M.D., and John R. Crochet, M.D.
BACKGROUND: Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy that occurs when a blastocyst implants in a defect of the hysterotomy site. Despite becoming increasingly more common, there is no consensus for management of CSP. Options include medical or surgical management. While traditional open surgical techniques are often utilized in these cases, new minimally invasive approaches need to be explored.

CASE: A 42-year-old woman with a history of infertility presented with CSP. Initially she underwent medical treatment with methotrexate and leucovorin, which ultimately failed. She elected to have a robotic resection of her CSP to maintain future fertility. She underwent an uncomplicated procedure and subsequently conceived and delivered via cesarean at 32 weeks’ gestation due to preterm labor.

CONCLUSION: While several options exist for management of CSP, robotic resection offers many benefits. The patient recovers quickly, has decreased follow-up time, and is able to quickly move forward with subsequent pregnancy if so desired. Providers should be aware of this novel, minimally invasive technique as well as other current treatment options.
Keywords:  cesarean section; laparoscopy; patient care management, pregnancy, ectopic; robotic surgical procedures; robotics
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