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Year : 2022  |  Volume : 11  |  Issue : 3  |  Page : 179-181

Laparoscopic management of cesarean scar pregnancy after medical treatment failure using laparoscopic bulldog clamps

1 Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Georgetown University Hospital, Washington, District of Columbia
2 Department of Obstetrics and Gynecology, Virginia Hospital Center, Arlington, Virginia, United States

Correspondence Address:
Dr. Stella Lii Blosser
5999, Burke Commons Road, Burke, VA 22015
United States
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/GMIT.GMIT_19_21

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Cesarean scar pregnancies are a rare complication of pregnancy, with an incidence rate of approximately 1 in 2000 pregnancies. Numerous treatment alternatives have been proposed and published for cesarean scar pregnancies (CSPs), including medical management with local or systemic methotrexate injection, resection through hysteroscopic, vaginal, abdominal or laparoscopic approach, and dilation and curettage. Concomitant strategies for achieving hemostasis/bleeding control have been attempted, including uterine artery embolization, the placement of a Foley balloon catheter, injection of vasopressin, and less commonly reported, the use of vascular clamps. We describe a case of failed medical management of a CSP, followed by laparoscopic resection with the use of vascular clamps to minimize bleeding. This approach can be considered for minimizing blood loss in the laparoscopic management of cesarean ectopic pregnancies.

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