Sezaryen Skar Gebeliğinde Sistemik Metotreksat ve Vajinal Misoprostol Tedavisi: Bir Olgu Sunumu

Sezaryen skar gebeliği SSG gestasyonel kesenin geçirilmiş sezaryen skarına implante olmasıyla ortaya çıkan nadir bir ektopik gebelik çeşididir. SSG masif hemoraji ve uterinrüptüre neden olabilir. SSG’nin ile ilgili çok sayıda prospektifr andomize kontrollü çalışmanın bulunmaması nedeniyle tanı ve tedavisi ile net bir konsensüs yoktur. Bu raporda tek doz sistemik metotreksat MTX ve vajinal misoprostol ile tedavi edilen SSG olgusu sunulmuştur. Tek doz MTX ve vajinal misoprostol kombinasyon tedavisi olgumuzda başarıyla sonuçlanmış olsa da sessiz rüptür veya masif hemoraji riskine karşı hastalar dikkatli şekilde takip edilmelidir. Tek doz MTX ve misoprostol kombinasyon tedavisinin güvenilirliğinin tam olarak ortaya konabilmesi için kapsamlı randomize çalışmalara gereksinim vardır.

Anahtar Kelimeler:

Metotreksat, misoprostol, sezaryen skar gebeliği

Systemic Methotrexate and Vaginal Misoprostol Treatment In Cesarean Scar Pregnancy: A Case Report

Cesarean scar pregnancy CSP is a rare kind of ectopic pregnancy caused by the implantation of the gestational sac on cesarean section scar. CSP can cause massive bleeding and uterine rupture. Due to the lack of prospectiver and omized controlled studies on CSP; there is no clear consensus about diagnosis and treatment. In this report, a CSP case reported, treated with single dose methotrexate MTX and vaginal misoprostol combination. Although; single- dose MTX and vaginal misoprostol combination was successful in our patient, the patients should be monitored carefully during this treatment against silent rupture and massive hemorrhage. The reandomized comprehensive studies are needed to reveal the reliability of a single dose of MTX and misoprostol combination therapy.

Keywords:

Cesarean scar pregnancy, methotrexate, misoprostol,

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