Acquired Uterine Arteriovenous Malformation with Scar Ectopic Pregnancy

Abstract

Background & Aim: A cesarean scar ectopic pregnancy is a rare type of ectopic pregnancy where implantation in a previous cesarean scar has occurred in the anterior and lower part of the uterus. May be associated with profuse bleeding. This condition can become life threatening when combined with arteriovenous malformation (AVM).

This is a rare case of ectopic pregnancy in a cesarean scar with an arteriovenous malformation. The diagnosis was made using ultrasound with the use of colored echo-Doppler and Power Doppler, which showed a block of blood vessels in the area of cesarean scar ectopic pregnancy ​​. It was treated conservatively with a weekly intramuscular injection of methotrexate. The values ​​of (β-hCG) decreased, but the surgical intervention was performed by opening an emergency abdomen as a result of the profuse life-threatening bleeding due to the arteriovenous malformation associated with this case, as this vascular malformation was removed while preserving the uterus and the woman's reproductive future.

A small number of cases of cesarean scar ectopic pregnancy with acquired AVM have been mentioned in the medical literature. There is still no agreement on the most appropriate treatment for these cases.