Мать и дитя в Кузбассе (Nov 2020)
ECTOPIC PREGNANCY IN THE SCAR AFTER CESAREAN SECTION
Abstract
In recent decades, there has been a steady increase in the frequency of operative deliveries performed by cesarean section, which inevitably leads to an increase in the likelihood of long-term risks, including an increase in the frequency of ectopic location of the fetal egg. Tubal localization of the fetal egg is the most common, accounting for up to 95.0 % of all cases. Among the rarer forms are found: ovarian, abdominal, cervical, interstitial, and heterotopic pregnancies. Since 2017, in the clinical recommendations approved by the Russian society of obstetricians and gynecologists and agreed with the Ministry of health of the Russian Federation, the classification of ectopic location of the fetal egg includes pregnancy located in the rumen after cesarean section. According to the literature, the frequency of this type of ectopic pregnancy is 0.15 %. Ultrasound criteria for this disease are thinning of the anterior wall of the uterus in the area of the scar, invasion. The article presents a clinical case of ectopic pregnancy of rare localization located in the area of the scar after cesarean section. The complexity of timely diagnosis and the risks of pregnancy located in the rumen have been demonstrated. Unstable hemodynamics and the presence of hemorrhagic shock did not allow for organ-preserving treatment. According to absolute indications, the patient underwent an organ-carrying operation (hysterectomy).
