Cesarean Scar Pregnancy Control and Termination by Foley Catheter

Background: Cesarean scar pregnancy is one of the most dangerous type of ectopic pregnancy with high mortality and morbidity rate.Because of the high cesarean section rate in developing countries we should pay attention to the alarm signs of this type of pregnancy to prevent its complications.Case presentation: A 38-years old woman was admitted because of spotting and abdominal pain.Her period had a 2-week retard .Her vital signs were stable and her pregnancy test was positive.Her past history included 2 previous cesarean sections.Vaginal sonography was done and a gestational sac(6 weeks) with fetal pole and yolk sac was reported in the previous cesarean section site .According to mother s stable condition ,we decided to try foley catheter insertion in the site of cesarean scar pregnancy in uterine cavity and filled up the bag of the foley under the sonography guide,and then we let it there for 48 hours while observing the patient,too.After 48 hours,we discontinued foley catheter and brought it out.Then we controlled the patient by doing transvaginal sonography and we observed that the sac was compacted .Then we prescribed a single dose of methotrexate for mother and a few days later we checked the B-hcg and we observed the decreasing titer,and then discharged the mother.Conclusion: Using the foley catheter in the right time by having low expense and without needing a surgery and by saving the uterus may be a good way to treat the cesarean scar pregnancy.