تلخیص
Objective: To compare the efficacy of laparotomy versus vaginal dilatation and evacuation in the management of cesarean scar
pregnancy in low resource setting.
Study Design: Comparative interventional study
Place and Duration: Gynaecology department of Nishtar Medical University from 1st June, 2016 to 30th May, 2017 over the period of
one year.
Methodology: Total 24 patients were included in study, divided on the basis of treatment modality in two groups, group-A underwent
laparotomy and resection of cesarean scar pregnancy while group-B underwent dilatation and evacuation of products of conception
vaginally. Independent sample t-test is applied to compare the performance of two procedures by comparing integrity of scar,
operative time, blood transfusion and intra peritoneal hemorrhage.
Results: Patients of group-A underwent laparotomy. There was intact scar, no blood transfusion and shorter operative time
(30±15min) with smooth recovery. Patients of groups-B underwent dilatation and evacuation vaginally, 83.3% patients had moderate
bleeding so their procedure was converted to laparotomy immediately and 16.7 % patients underwent laparotomy after period of
observation because of hypovolemic shock. In this group 33.3% patients were found to have disrupted scar, 33.3% had intraperitoneal
hemorrhage, 16.7% had blood transfusions and longer operation time (60±15min).
Conclusion: Laparotomy is better than vaginal procedure to reduce morbidity in cesarean scar pregnancy in low resource setting.
Saima Yasmin Qadir, Syeda Ali, Shazia Siddiq. (2019) Cesarean scar pregnancy; an institutional experience, Isra Medical Journal, Volume 11, Issue 2.
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