Arnold Advincula's Surgical Techniques

Intragestational injection of methotrexate

Author and Disclosure Information

Treatment of cesarean scar ectopic pregnancy


The presentation of a cesarean scar ectopic pregnancy can at times be daunting, especially without familiarity regarding its management. Women with cesarean scar ectopic pregnancy most often have no symptoms, although vaginal bleeding and abdominal pain can present. Upon visual diagnosis with transabdominal or transvaginal ultrasound, the preferred treatment method is direct injection of methotrexate into the gestational sac within the cesarean scar.

In this video, my colleagues review the indications and contraindications for direct injection of methotrexate as well as alternative treatment methods for this type of nonviable pregnancy that is increasing in frequency (given the US cesarean delivery rate). Demonstrated is the technique for methotrexate injection in the case of a 34-year-old woman (G6P0232) with ultrasound and beta−human chorionic gonadotropin confirmation of cesarean scar ectopic pregnancy.

We hope this video serves as a useful reference in your practice.

Vidyard Video

Share your thoughts on this video! Send your Letter to the Editor to Please include your name and the city and state in which you practice.

Next Article:

Does labor induction (vs expectant management) increase the risk of failed TOLAC?

Related Articles