Operative Therapy for Heterotopic Scar Pregnancy and Successful Birth of the Intrauterine Foetus – Case Report and Review of the Literature

Abstract

A heterotopic pregnancy in the vicinity of a previous Caesarean section scar (HSP) occurs frequently after fertility treatment. In spite of the low incidence to date, the increasing numbers of Caesarean sections as well as IVF treatment will probably lead to a higher prevalence in the future. Up to now the literature contains only isolated case reports on therapeutic options. These range from conservative management through selective termination of the HSP by injections of methotrexate or potassium chloride into the amniotic sac to invasive methods such as resectoscopic removal or laparoscopy. In the case presented here we describe the successful excision of the HSP by laparotomy with a subsequent uncomplicated Caesarean section and delivery of a healthy baby at the 37 + 0 week of pregnancy.

Zusammenfassung

Eine heterotope Schwangerschaft im Bereich einer ehemaligen Sectionarbe (HNG) entsteht häufig nach Kinderwunschbehandlung. Trotz bisher niedriger Inzidenz ist aufgrund steigender Raten abdomineller Schnittentbindungen sowie IVF-Behandlungen mit einer erhöhten Prävalenz zu rechnen. Bisher existieren in der Literatur nur einzelne Fallberichte über Therapiemöglichkeiten. Diese reichen von konservativem Management über selektive Terminierung der HNG durch Injektion von Methotrexat oder Kaliumchlorid in die Fruchthöhle bis zu invasiveren Methoden wie resektoskopischer Entfernung oder der Laparoskopie. Bei dem hier dargestellten Fall wird eine erfolgreiche Exzision der HNG per Laparotomie dargestellt mit anschließend unkomplizierter Sectio caesarea und Geburt eines gesunden Neugeborenen bei 37 + 0 Schwangerschaftswochen.

Key words

assisted reproduction - extrauterine pregnancy - uterus

Schlüsselwörter

assistierte Reproduktion - Extrauteringravidität - Uterus

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