Mimoděložní těhotenství v molární oblasti s jizvou po císařském řezu léčenou methotrexátem – kazuistika a přehled literatury

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Autoři: E. Yücel ¹ ; İbrahim Kale ¹ ; O. Şanlı ¹ ; A. N. İhvan ²
Působiště autorů: Department of Obstetrics and Gynecology, Umraniye Training and Research Hospital, Istanbul, Turkey ¹; Department of Pathology, Umraniye Training and Research Hospital, Istanbul, Turkey ²
Vyšlo v časopise: Ceska Gynekol 2026; 91(1): 56-60
Kategorie: Kazuistika
doi: https://doi.org/10.48095/cccg202656

Souhrn

Objective: To present a rare case of partial molar pregnancy implanted in a previous cesarean section scar and summarize the literature. Case report: A 33-year-old woman (gravida 5, two prior cesarean deliveries, two spontaneous abortions) presented with vaginal spotting and lower abdominal pain at 6 weeks of gestation. Transvaginal ultrasonography revealed a 28 × 19 mm gestational sac at the cesarean scar site, containing a 4mm fetus with positive cardiac activity. Vacuum curettage was performed under ultrasonographic guidance. Ten days postprocedure, rising serum beta-hCG levels and a persistent cystic mass on ultrasound raised suspicion for molar pregnancy. A single systemic dose of methotrexate was administered. Histopathology confirmed a partial molar pregnancy. The patient’s serum beta-hCG levels normalized within 8 weeks. Conclusion: Partial molar pregnancy in a cesarean section scar is an extremely rare condition that may present with vaginal bleeding and pelvic pain. Early recognition through ultrasonography and laboratory evaluation, combined with timely intervention including curettage and methotrexate therapy, can lead to complete resolution. Clinicians should consider this diagnosis in patients with previous cesarean sections to ensure optimal outcomes.

Klíčová slova:

Methotrexate – cesarean section scar – molar pregnancy – partial hydatidiform mole – vacuum curettage

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Zdroje

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ORCID of authors

E. Yücel 0000-0002-5941-1926

İ. Kale 0000-0001-7802-7199

O. Şanlı 0009-0001-4737-0872

A. N. İhvan 0009-0009-3843-9688

Submitted/Doručeno: 1. 9. 2025

Accepted/Přijato: 5. 10. 2025

Assoc. Prof. İbrahim Kale, MD

Department of Obstetrics and Gynecology

Umraniye Training and Research Hospital

Elmalıkent, Adem Yavuz Cd.

34764 Ümraniye/İstanbul