A Case of Treatment with Methotrexate Local Injection on Intramural Pregnancy within a Previous Cesarean Scar.

Park, Sang Woo; Shin, Kyu Sik; Kim, Myeon Soo; Ku, Seon Yeong; Kim, Yu Ri; Kwak, Tae Ro

Case Report

Korean Journal of Obstetrics & Gynecology 2006;49(1):208-212.
Published online January 1, 2006.

A Case of Treatment with Methotrexate Local Injection on Intramural Pregnancy within a Previous Cesarean Scar.

Sang Woo Park, Kyu Sik Shin, Myeon Soo Kim, Seon Yeong Ku, Yu Ri Kim, Tae Ro Kwak

Department of Obstetrics and Gynecology, Wallace Memorial Baptist Hospital, Busan, Korea. memory137@hanmail.net

Abstract

Intramural pregnancy on a cesarean section scar is one of the rarest forms of ectopic pregnancy that may cause serious complications such as uterine rupture and massive bleeding. The common treatment in the past was laparotomy, but today early diagnosis is available thanks to the development of image diagnostic technology and, as a consequence, cases of less invasive conservative management are reported. Using vaginal ultrasonography and MRI, we made an early diagnosis on a case of intramural pregnancy on the scar of a previous cesarean section. We injected methotrexate locally into the gestational sac, and the intramural pregnancy was completely cured. Thus, here we report this case with a brief review of relevant literature.

Key Words: Intramural pregnancy, Cesarean section scar