September 15th, 2019

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Expectant Management of Heterotopic Cesarean Scar Pregnancy: A Case Report
Authors:  Qian Yin, M.D., Zhen-bo OuYang, M.D., Hong-wei Li, M.D., Mei Zhong, Ph.D., and Song Quan, Ph.D.
BACKGROUND: Heterotopic pregnancy is defined as the coexistence of intrauterine and extrauterine gestations. Heterotopic cesarean scar pregnancy is one of the rarest forms of heterotopic pregnancy; little is known about the optimal therapeutic protocol for its management. The objective of this article is to present a case of heterotopic cesarean scar pregnancy treated successfully by expectant management and to review published cases.

CASE: A 33-year-old woman was diagnosed with heterotopic cesarean scar pregnancy by ultrasound after IVF-ET. She chose expectant management because the cesarean scar pregnancy expired spontaneously. After an uneventful period of gestation she gave birth to a healthy male neonate by emergency cesarean section necessitated by placenta previa. Although >1,500 mL blood was lost during the operation, the uterus was preserved successfully.

CONCLUSION: The viable intrauterine pregnancy coexisting with heterotopic cesarean scar pregnancy can be preserved successfully, despite the many risks during the prenatal and perinatal period.
Keywords:  cesarean scar; cesarean section; ectopic pregnancy; expectant management; fetal termination, selective; heterotopic cesarean scar pregnancy; pregnancy, heterotopic; selective embryo reduction in situ
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