Myomectomy Scar Pregnancy: A Rare Complication of Myomectomy

Abstract

Abstract

Background:

Myomectomy scar pregnancy is a rare form of intramural pregnancy in which the gestational sac is implanted within the myometrium, separate from the endometrial cavity and fallopian tubes and in the previous myomectomy scar. This review was written to increase awareness about the rare complication of intramural scar pregnancy after myomectomy. Illustrated by a case report of a myomectomy scar pregnancy following laparoscopic myomectomy, the review covers 3 cases reported in the literature.

Illustrative Case:

A 31-year-old female, gravida 3, with a history of myomectomy presented to the Centre for Advanced Endoscopy and Infertility of Paul's Hospital in Kochi, Kerala, India, at 9 weeks of gestation for confirmation of fetal viability. A transvaginal ultrasound scan indicated that there was a potential left interstitial pregnancy. However, laparoscopy revealed that this patient actually had an intramural pregnancy in her previous myomectomy scar. This patient's condition was managed successfully via laparoscopy.

Results:

An electronic database search yielded 68 cases of intramural scar pregnancy. However, only 3 cases of intramural scar pregnancies after myomectomy were identified.

Conclusion:

An unusual location of an early pregnancy on TVS should raise the suspicion of myomectomy scar ectopic pregnancy in a woman with a previous myomectomy. (J GYNECOL SURG 34:53)