:: Volume 25, Issue 2 (4-2020) ::
__Armaghane Danesh__ 2020, 25(2): 264-274 Back to browse issues page
Pregnancy in a Cesarean Section: A Case Study
E Bahrami Vazir1 , A Mansouri2 , A Farshbaf Khalili3 , F Ghelich Khani4 , A Mohammadi 5
1- Department of Midwifery, Ilam University of Medical Sciences, Ilam, Iran
2- Department of Midwifery, Alborz University of Medical Sciences, Alborz, Iran
3- Research Centers for Physical Medicine and Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran,
4- Department of Midwifery, Iran University of Medical Sciences, Tehran, Iran
5- Nursing and Midwifery Research Center, Tehran University of Medical Sciences, Tehran Iran , mohammadi_a222@yahoo.com
Abstract:   (5327 Views)
Background & aim: Pregnancy at cesarean section is rare and delays in diagnosis and treatment are associated with maternal complications, but diagnostic and treatment methods are being studied due to its rarity and there is no standard protocol for pregnancy management at cesarean section. . The purpose of the present report was to provide a method of early diagnosis and treatment of pregnancy at the site of cesarean section.
 
Case Report: A 34-year-old woman with a second pregnancy, gestational age of 8 weeks and 3 days, and a history of a cesarean section complained of spotting and severe abdominal pain. The amount of β human placental gonadotropin (β-hCG) was reported to be 5600 mmol/ml. In transvaginal ultrasound, the gestational sac containing internal echoes without a embryonic pole was seen at the site of the previous cesarean section and the blood flow around the gestational sac. The patient was followed up for 3 days for spontaneous abortion of ectopic pregnancy or reduction of gestational sac size in the hospital. Due to the increase in β-hCG, dilatation and suction curettage and hysteroscopic resection were performed. Twenty-four hours after treatment, the first β-hCG, 191 mmol/ml, was reported. The next study was performed in two stages at 48-hour intervals and had a downward trend. Then, a week later, the β-hCG level was increased to 30 mmHg. The millimeter had arrived. After 11 days of follow-up, follow-up was stopped due to a decrease in β-hCG.
 
Conclusion: In the present patient, pregnancy at the cesarean section was diagnosed with transvaginal ultrasound in the early stages and appropriate treatment was performed with dilatation and suction cortex and hysteroscopic resection. In pregnant women, with the complaint of vaginal spotting and a history of previous cesarean section, the possibility of miscarriage at the cesarean section should always be considered to prevent further possible complications and the possibility of uterine removal.

 
 
Keywords: Ectopic Pregnancy, Cesarean Section, Suction Curettage, Hysteroscopy
Full-Text [PDF 1486 kb]   (519 Downloads)    
Type of Study: case report | Subject: Gynaecology
Received: 2019/07/2 | Accepted: 2020/02/9 | Published: 2020/05/4



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Volume 25, Issue 2 (4-2020) Back to browse issues page