Taiwanese Journal of Obstetrics and Gynecology
Volume 44, Issue 2 , Pages 168-171, June 2005

Methotrexate Followed by Suctional Curettage: A Successful Treatment for Cesarean Scar Pregnancy

  • Yen-Yen Lim

      Affiliations

    • Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Chin-Yuan Hsu

      Affiliations

    • Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr. Chin-Yuan Hsu, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, 92, Section 2, Chung-Shan North Road, Taipei, Taiwan
    • ,
  • Chih-Ping Chen

      Affiliations

    • Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
    • National Yang-Ming University, Taipei, Taiwan

Received 23 July 2004; received in revised form 23 July 2004; accepted 23 July 2004.

Summary 

Objective

To report the conservative management of a patient with cesarean scar pregnancy.

Case Report

A 28-year-old woman, gravida 3, para 2, was initially diagnosed by transvaginal sonography to have a single viable gestation in a uterine scar. A single dose of systemic methotrexate 50 mg was given intramuscularly. A suctional curettage was then performed successfully. Serum levels of β-human chorionic gonadotropin returned to normal 21 days later. The patient had suffered from persistent vaginal spotting for 2 months, but no major complications were noted at follow-up.

Conclusion

To preserve fertility, systemic intramuscular methotrexate followed by suctional curettage may be a safe treatment alternative for cesarean scar pregnancies.

Key Words:  cesarean scar pregnancy , methotrexate , transvaginal ultrasonography

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PII: S1028-4559(09)60132-7

doi:10.1016/S1028-4559(09)60132-7

Taiwanese Journal of Obstetrics and Gynecology
Volume 44, Issue 2 , Pages 168-171, June 2005

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