Cesarean scar pregnancy combined with arteriovenous malformation successfully treated with transvaginal fertility-sparing surgery: A case report and literature review

A cesarean scar pregnancy (CSP), when combined with an arteriovenous malformation (AVM), is a rare, but potentially life-threatening condition that may be associated with uncontrolled hemorrhage. Hysterectomy is indicated when conservative treatment fails. Preservation of fertility is challenging. W...

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Published inMedicine (Baltimore) Vol. 99; no. 31; p. e21432
Main Authors Li, Xiangjuan, Sun, Wenchao, Chen, Lingna, Jin, Mei, Zhang, Zhifen, Gao, Jiansong, Fei, Xiaoyang
Format Journal Article
LanguageEnglish
Published United States the Author(s). Published by Wolters Kluwer Health, Inc 31.07.2020
Wolters Kluwer Health
Subjects
Adult
Angiography - methods
Antimetabolites, Antineoplastic - administration & dosage
Antimetabolites, Antineoplastic - therapeutic use
Arteriovenous Malformations - complications
Arteriovenous Malformations - diagnostic imaging
Arteriovenous Malformations - drug therapy
Arteriovenous Malformations - surgery
Cesarean Section - adverse effects
Cicatrix - pathology
Cicatrix - surgery
Clinical Case Report
Female
Fertility Preservation - methods
Humans
Imaging, Three-Dimensional - methods
Magnetic Resonance Imaging - methods
Methotrexate - administration & dosage
Methotrexate - therapeutic use
Pregnancy
Pregnancy, Ectopic - surgery
Treatment Outcome
Ultrasonography, Doppler, Color - methods
Online AccessGet full text

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Abstract A cesarean scar pregnancy (CSP), when combined with an arteriovenous malformation (AVM), is a rare, but potentially life-threatening condition that may be associated with uncontrolled hemorrhage. Hysterectomy is indicated when conservative treatment fails. Preservation of fertility is challenging. We reported a 33-year-old woman with a CSP combined with an AVM who failed methotrexate administration as conservative treatment. A CSP combined with an AVM was diagnosed via three-dimensional color Doppler angiogram and magnetic resonance imaging. Transvaginal removal of the ectopic gestation and repair of the uterine defect was performed without incident. The fertility of the patient was preserved and hysterectomy was avoided. Transvaginal fertility-sparing surgery may be successfully performed to prevent hysterectomy when conservative treatment fails in patients with a CSP combined with an AVM.
AbstractList A cesarean scar pregnancy (CSP), when combined with an arteriovenous malformation (AVM), is a rare, but potentially life-threatening condition that may be associated with uncontrolled hemorrhage. Hysterectomy is indicated when conservative treatment fails. Preservation of fertility is challenging. We reported a 33-year-old woman with a CSP combined with an AVM who failed methotrexate administration as conservative treatment. A CSP combined with an AVM was diagnosed via three-dimensional color Doppler angiogram and magnetic resonance imaging. Transvaginal removal of the ectopic gestation and repair of the uterine defect was performed without incident. The fertility of the patient was preserved and hysterectomy was avoided. Transvaginal fertility-sparing surgery may be successfully performed to prevent hysterectomy when conservative treatment fails in patients with a CSP combined with an AVM.
A cesarean scar pregnancy (CSP), when combined with an arteriovenous malformation (AVM), is a rare, but potentially life-threatening condition that may be associated with uncontrolled hemorrhage. Hysterectomy is indicated when conservative treatment fails. Preservation of fertility is challenging.INTRODUCTIONA cesarean scar pregnancy (CSP), when combined with an arteriovenous malformation (AVM), is a rare, but potentially life-threatening condition that may be associated with uncontrolled hemorrhage. Hysterectomy is indicated when conservative treatment fails. Preservation of fertility is challenging.We reported a 33-year-old woman with a CSP combined with an AVM who failed methotrexate administration as conservative treatment.PATIENT CONCERNSWe reported a 33-year-old woman with a CSP combined with an AVM who failed methotrexate administration as conservative treatment.A CSP combined with an AVM was diagnosed via three-dimensional color Doppler angiogram and magnetic resonance imaging.DIAGNOSESA CSP combined with an AVM was diagnosed via three-dimensional color Doppler angiogram and magnetic resonance imaging.Transvaginal removal of the ectopic gestation and repair of the uterine defect was performed without incident.INTERVENTIONSTransvaginal removal of the ectopic gestation and repair of the uterine defect was performed without incident.The fertility of the patient was preserved and hysterectomy was avoided.OUTCOMESThe fertility of the patient was preserved and hysterectomy was avoided.Transvaginal fertility-sparing surgery may be successfully performed to prevent hysterectomy when conservative treatment fails in patients with a CSP combined with an AVM.CONCLUSIONTransvaginal fertility-sparing surgery may be successfully performed to prevent hysterectomy when conservative treatment fails in patients with a CSP combined with an AVM.
Author Li, Xiangjuan
Zhang, Zhifen
Chen, Lingna
Gao, Jiansong
Jin, Mei
Sun, Wenchao
Fei, Xiaoyang
AuthorAffiliation Department of Female Pelvic Medicine and Reconstructive Surgery
Department of Ultrasonography, Hangzhou Women's Hospital, Hangzhou, China
Department of Gynecology
Center of Reproductive Medicine
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  doi: 10.1002/jcu.20848
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Snippet A cesarean scar pregnancy (CSP), when combined with an arteriovenous malformation (AVM), is a rare, but potentially life-threatening condition that may be...
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SubjectTerms Adult
Angiography - methods
Antimetabolites, Antineoplastic - administration & dosage
Antimetabolites, Antineoplastic - therapeutic use
Arteriovenous Malformations - complications
Arteriovenous Malformations - diagnostic imaging
Arteriovenous Malformations - drug therapy
Arteriovenous Malformations - surgery
Cesarean Section - adverse effects
Cicatrix - pathology
Cicatrix - surgery
Clinical Case Report
Female
Fertility Preservation - methods
Humans
Imaging, Three-Dimensional - methods
Magnetic Resonance Imaging - methods
Methotrexate - administration & dosage
Methotrexate - therapeutic use
Pregnancy
Pregnancy, Ectopic - surgery
Treatment Outcome
Ultrasonography, Doppler, Color - methods
Title Cesarean scar pregnancy combined with arteriovenous malformation successfully treated with transvaginal fertility-sparing surgery: A case report and literature review
URI https://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00005792-202007310-00082
https://www.ncbi.nlm.nih.gov/pubmed/32756152
https://www.proquest.com/docview/2430980520
https://pubmed.ncbi.nlm.nih.gov/PMC7402736
Volume 99
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