Laparoscopic surgery of ectopic gestational sac implanted in the cesarean section scar.

AIM

The feasibility and outcome of laparoscopic surgery for patients with ectopic pregnancy in the cesarean section scar was studied.

METHODS

From January 2003 to June 2007, 7 of 9 patients diagnosed with ectopic pregnancy in a previous cesarean section scar underwent laparoscopic removal of the gestational sac at our department. A retrospective review of medical records of these patients was performed.

RESULTS

In all of them, the ectopic gestational sac was successfully removed by laparoscopy without converting to laparotomy and the scar defect was repaired by intracorporeal sutures. The mean operation time was 98 minutes (range: 30 to 210 min) and mean hemoglobin drop after operation was 2.3 g/dL (range: 1.2 to 3.4 g/dL). The mean postoperative hospital stay was 4.3 days (range: 3 to 7 d). None of the patients required additional methotrexate administration postoperatively.

CONCLUSIONS

Laparoscopic removal of ectopic gestational sac within a cesarean scar seems to be a feasible and safe procedure that might be considered as a treatment option.