Successful selective reduction of a heterotopic cesarean scar pregnancy in the second trimester: a case report and review of the literature. Issue 1 (December 2016)

• Record Type: Journal Article
• Authors: Yu, Haiyan; Luo, Hong; Zhao, Fumin; Liu, Xinghui; Wang, Xiaodong
• Is Part Of: BMC pregnancy and childbirth. Volume 16:Issue 1(2016)
• Page Start: 1
• Page End: 7
• Publication Date: 2016-12
• Subjects: Heterotopic cesarean scar pregnancy -- Potassium chloride -- Selective fetal reduction -- Expectant management; Pregnancy -- Periodicals; Childbirth -- Periodicals; Obstetrics -- Periodicals; 618.2005
• DOI: 10.1186/s12884-016-1171-x
• Languages: English
• ISSNs: 1471-2393

Abstract

Abstract Background Heterotopic cesarean scar pregnancy is a cesarean scar pregnancy combined with an intrauterine pregnancy that predisposes a woman to life-threatening complications such as uterine rupture and massive bleeding. Preservation of the intrauterine pregnancy in heterotopic cesarean scar pregnancy is a great challenge. Case presentation We report a case of a 33-year-old woman with heterotopic cesarean scar pregnancy after IVF-embryo transfer (ET). Expectant management was carried out with early diagnosis of heterotopic cesarean scar pregnancy (HCSP), and selective fetal reduction of cesarean scar pregnancy (CSP) was performed by ultrasound-guided intrathoracic injection of potassium chloride (KCl) at 16 + 4 weeks of gestation due to aggravation of CSP. Preservation of the intrauterine pregnancy was successful and a healthy baby was delivered by cesarean section at 37 + 6 weeks of gestation. Conclusions Heterotopic cesarean scar pregnancy is an extremely rare form of heterotopic pregnancy. Patients should be appropriately counseled regarding the different treatment options available. An ultrasound-guided injection of potassium chloride may constitute a safe, minimally invasive and reliable way to terminate the heterotopic gestation and preserve the intrauterine pregnancy. Intensive management should be performed during the ongoing pregnancy and cesarean section.