A CASE REPORT OF MANAGING CAESAREAN SCAR PREGNANCY WITH LOCAL POTASSIUM CHLORIDE
Abstract
Background: Caesarean scar pregnancy (CSP) is an uncommon type of ectopic pregnancy wherein a gestational sac develops in the myometrium of a previous caesarean section scar. The incidence of CSP is on the increase, associated with increasing caesarean delivery rates, and can cause uterine rupture and hemorrhage. Early diagnosis, as early as the third month of pregnancy, by means of transvaginal ultrasound is essential for its proper management. Case Presentation: In this study, we report the case of a 38-year-old Caucasian woman who had received two caesarean sections and a unicornuate uterus, who was evaluated after in vitro fertilization (IVF). At 8 weeks of gestation initial ultrasound showed a gestational sac which was consistent with CSP. Most supported sac and minimal myometrial thickness were seen on MRI. An ultrasound guided local potassium chloride injection was performed in the patient, given patient's preference for non-surgical therapy. Management: The patient was closely tracked following the injection. Following these ultrasounds, hCG levels decreased and more ultrasounds would show a nonviable pregnancy. In May 2024, follow up assessments demonstrated resolution of the CSP, with little to no complications, and return for normal menstrual function. Conclusion: This presentation describes CSP successfully managed without surgery by local injection of potassium chloride, which provides a promising means other than surgery to obtain fetal control, particularly early in gestation. In addition to preserving uterine integrity and future fertility, this approach may be applied to other CSPs as well. We are warranted to seek further research to assess how effective and safe this method could be in larger populations and establish standardized management protocols for CSP.