Laparoscopic management of heterotopic cesarean scar pregnancy with preservation of intrauterine gestation and delivery at term: case report

Objective: To present a case of laparoscopic removal of a heterotopic cesarean scar pregnancy under ultrasound guidance. Design: Case report. Setting: Private hospital. Patient(s): A 34-year-old woman with heterotopic cesarean scar pregnancy. Intervention(s): Laparoscopic removal of heterotopic cesarean scar pregnancy. Main Outcome Measure(s): Delivery at term after laparoscopic management of heterotopic cesarean scar pregnancy. Result(s): An ongoing intrauterine pregnancy ended with a live birth after successful removal of the heterotopic gestational mass by a laparoscopic approach. Conclusion(s): Surgical removal of the ectopic mass by laparoscopy may be a radical approach in cases of heterotopic cesarean scar pregnancy. Laparoscopic excision of the cesarean scar pregnancy gives the opportunity to preserve the viable intrauterine gestation while maintaining a strong lower uterine segment. Ultrasound is an adjunctive tool that enables precise location of the ectopic mass during the operation. (Fertil Steril (R) 2009;91:1293.e5-e7. (C) 2009 by American Society for Reproductive Medicine.)