7763 Hysteroscopic Morcellation (with Bigatti Shaver) Under Laparoscopic Guidance: A Novel Approach to Management of Caesarean Scar Pregnancy

Study ObjectiveTo present our experience in treating cases with caesarean scar pregnancy by hysteroscopic morcellation using Bigatti Shaver over a period of 1 year.DesignLongitudinal prospective study for 1 year & follow up done till beta HCG level comes to normal.SettingPatients positioning in the OT table: Lithotomy position, 45-degree angle between OT table & patients elevated legs. 2 Endomat Select: one for irrigation & other for suction, RPM-2100, Irrigation: 200-250 ml/min, Pressure: 150mm of HgPatients or Participants10 women between age 22-35years presented to us in the OPD with caesarean scar pregnancy confirmed on their dating ultrasound.InterventionsPre operative investigations were done prior to surgery and under laparoscopy they were posted for surgical intervention - removal of scar pregnancy by Bigatti Shaver.Measurements and Main Results• No fertility desired by the patient further, so patient should be tubectomised • It should be done till 7 weeks of period of gestation • Myometrial thickness should be between 2 to 4 mmResults1. None had any intra or post operative complications. 2. Average duration of procedure: less than half an hour & blood loss less than 100ml. 3. Serial Beta HCG from the day of discharge and weekly therefore done, which returned to non-pregnant levels by end of 4 weeks.ConclusionHysteroscopic morcellation is a convenient and effective mode of management of caesarean scar pregnancy with excellent safety profile and patient satisfaction rates.