Type 2 Cesarean Scar Pregnancy Successfully Treated Via Hysteroscopy-Assisted Laparoscopy

Study Objective: To evaluate the efficacy of hysteroscopy-assisted laparoscopy as a treatment strategy for type 2 cesarean scar pregnancy at gestational age >8 weeks.

Design: Retrospective case series (Canadian Task Force classification II-3).

Setting: A tertiary hospital.

Patients: Eight women with type 2 cesarean scar pregnancy at a gestational age >8 weeks.

Interventions: All patients underwent hysteroscopy-assisted laparoscopic resection and isthmus repair of cesarean scar pregnancy.

Measurements And Main Results: All patients underwent removal of the cesarean scar pregnancy and complete repair of the uterine scar defect. The median operative time was 123.0 minutes (range, 100-168 minutes), median blood loss was 65.0 mL (range, 20-100 mL), and median length of hospital stay was 9.1 days (range, 8-12 days). There were no adverse reactions. The mean time to serum β-human chorionic gonadotropin (β-HCG) resolution was 22.9 days (range, 14-30 days), and menstruation resumed after 9 to 15 days with serum β-HCG returning to nondetectable levels. There was no recurrence of cesarean scar pregnancy at long-term follow-up.

Conclusion: Hysteroscopy-assisted laparoscopy may be an effective treatment for patients with type 2 cesarean scar pregnancy at gestational age >8 weeks.