Selection of the surgical intervention in rare cases of ectopic pregnancy: clinical cases

Ectopic pregnancy is a significant problem of modern gynecology. Recently, a new variant of ectopic pregnancy with localization in the area of the surgical scar after cesarean section has appeared. The etiology of cervical pregnancy is still unknown. Both types have a high threat to a woman's life and health. There is certain treatment strategies aimed at preserving fertility. However, the urgency of the situation affects the choice of method and volume of operative treatment. The aim of the work was to substantiate the adequacy of access and the extent of surgical intervention in patients with ectopic pregnancy according to the clinical situation. Clinical cases. This article demonstrates 2 cases of ectopic pregnancy that required hysterectomy. In the first case, an emergency hysteroresectoscopy was performed on a patient with vaginal bleeding due to an ectopic pregnancy in the area of the cesarean scar. However, it was not possible to stop the bleeding via coagulation of the vessels due to significant thinning and hypervascularization of the niche area. Therefore, the intervention was expanded to laparoscopy, hysterectomy. The second patient with a cervical pregnancy confirmed via ultrasonography was attended in a severe status due to a hemorrhagic shock clinic. She has been performed a laparotomy and hysterectomy. The described clinical cases demonstrate that the bleeding and hemodynamic instability of the patient affect the choice of the volume of intervention in rare cases of ectopic pregnancy. The study was conducted in accordance with the principles of the Helsinki Declaration. Informed consent was obtained from all patients. The authors declare no conflict of interest.