Ömer DEMİRTAŞ, Gülşah DEMİRTAŞ, Emre GÜLTEKİN, Bülent YEŞİLYURT

Spontaneous resolution of a scar pregnancy after an unsuccessful dilatation and curettage

Sezaryen skar gebeliği (SSG), ektopik gebeliğin çok nadir görülen ancak ciddi komplikasyon oluşturabilecek bir türüdür. 35 yaşında, gravida 4, parite 3 ve 6 ay önce geçirilmiş sezaryen öyküsü bulunan hasta, minimal vajinal kanama ve orta derecede pelvik ağrı şikayetleri ile hastanemize başvurdu. Ultrasonografik incelemede, uterus alt segment ön duvarına yerleşmiş, vezikouterin alana bitişik, düzgün sınırlı, 12*16*11 mm boyutlarında (5 hafta 6 günlük) gebelik kesesi izlendi. Olguya dilatasyon küretaj uygulandı ancak prosedür başarısız oldu. Sonrasında hasta izlem tedavisine alındı. HCG rezolusyon zamanı 40-50 gün idi. Normal uterin anatomiye, komplikasyon olmadan 103 gün sonra ulaşıldı. 6 ay sonra hasta tekrar normal intrauterin gebelik sahibi oldu. SSG'de, morbiditeyi azaltmak ve fertiliteyi korumak için olabildiğince erken tanı konulmalıdır. İlk trimesterde, erken haftalarda tespit edilen seçilmiş vakalarda, izlem tedavisi seçenek olabilir.

Skar gebeliğinin başarısız dilatasyon ve kürtajdan sonra spontan rezolusyonu: Olgu sunumu

Cesarean scar pregnancy (CSP) is the rarest kind but serious complication of ectopic pregnancy. We presented a 35 year-old woman gravida 4, para 3, with a prior history of cesarean section before 6 months ago was admitted to our department with minimal vaginal bleeding and pelvic pain. Ultrasonographic evaluation revealed a regular well-defined gestational sac (GS) located in the lower segment of anterior uterine wall, adjacent to the vesicouterine space, 12*16*11 mm in size (5week 6 day). The case was managed by dilatation and curettage but procedure was unsuccessful. Patient was followed up by expectant management. The hCG resolution time was 40-50 days. Normal uterin anatomy was achieved after 103 days without complications. About 6 months later the patient has conceived intrauterin pregnancy. CSP should be diagnosed and treated as soon as possible to reduce morbidity and preserve fertility. Expectant management can be performed for selected patients detected in early first trimester.

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