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Vol. 47. Núm. 8.
Páginas 393-399 (Enero 2004)
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Vol. 47. Núm. 8.
Páginas 393-399 (Enero 2004)
DOI: 10.1016/S0304-5013(04)76025-2
Acceso a texto completo
Gestación ectópica sobre cicatriz de cesárea anterior: caso clínico y revisión de la literatura
Ectopic pregnancy in a cesarean section scar: case report and review of the literature
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D. Escribano, M. Gallego, A. Galindo
Autor para correspondencia
agalindo.hdoc@salud.madrid.org

Correspondencia: Departamento de Obstetricia y Ginecología. Hospital Universitario Materno-Infantil 12 de Octubre. Carretera de Andalucía, Km 5,400. 28041 Madrid. España
, M.L. Palomo, J. Alonso, P. de la Fuente
Departamento de Obstetricia y Ginecología. Hospital Universitario Materno-Infantil 12 de Octubre. Madrid. España
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Resumen

La gestación sobre la cicatriz de una cesárea anterior es la forma más rara de embarazo ectópico que puede acarrear graves complicaciones, como la rotura uterina o hemorragias graves, y requiere la realización de histerectomía. Sin embargo, con ecografía transvaginal es posible su diagnóstico precoz y la aplicación de tratamiento conservador. Se han descrito varias modalidades terapéuticas, y se ha señalado la inexistencia de una que sea idónea para todos los casos

Presentamos un caso de gestación ectópica sobre la cicatriz de una cesárea anterior diagnosticada mediante ultrasonografía en la sexta semana de amenorrea. Se realizó tratamiento conservador con éxito mediante la administración combinada de metotrexato sistémico e intrasacular, negativizándose los valores de gonadotropinas en la sexta semana. Las diferentes opciones terapéuticas, sus ventajas e inconvenientes, se discuten en el texto

Palabras Clave:
Gestación ectópica
Cicatriz de cesárea
Metotrexato
Abstract

Pregnancy in a previous cesarean scar is the rarest of all ectopic pregnancies with the potential for severe complications such as uterine rupture and hemorrhage, requiring an emergency hysterectomy. However, the advent of transvaginal sonography has enabled earlier diagnosis and the application of more conservative therapeutic approaches. Several modalities have been proposed, revealing that no single option is suitable for all cases

We describe the case of an ectopic pregnancy that developed in a previous cesarean section scar and was diagnosed by ultrasound at 6 weeks of amenorrhea. It was successfully treated by combined administration of methotrexate, bothsystemic and intrasac. Human chorionic gonadotropin returned to non-pregnancy levels at 6 weeks. The various therapeutic strategies and their advantages and disadvantages are discussed

Key Words:
Ectopic pregnancy
Cesarean section scar
Methotrexate
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Copyright © 2004. Sociedad Española de Ginecología y Obstetricia
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