Successful Conservative Management of an Unruptured Cesarean Scar Ectopic Pregnancy

Excerpt

Cesarean scar pregnancy (CSP) is the rarest form of all ectopic gestations with recently reported incidence ranging from 1:1800 to 1:2216 [1]. Any uterine scar from previous cesarean, hysterotomy, myomectomy, vigorous curettage, metroplasty etc. can be nidus for embryo implantation resulting into scar ectopic gestation. This condition has been associated with life-threatening complications like uterine rupture, hemorrhage and DIC with increased operative morbidity and mortality. Clinical presentation may vary from vaginal bleeding with or without pain to signs and symptoms of scar rupture or shock. Role of Transvaginal ultrasonography in making early diagnosis is of utmost importance. Management mainly depends upon patient’s clinical presentation, hemodynamic stability and future desire for fertility. Different treatment options are scar site repair after wedge resection or hysterectomy either by laparotomy or laparoscopically, local or systemic methotrexate, curettage, uterine artery chemoembolization [2]. …