Caesarean section scar pregnancy: a case series

Authors

  • Tan Ying An Department of Obstetrics and Gynaecology, Hospital Tuanku Jaafar, Jalan Rasah, Seremban, Malaysia
  • Kavitha Nagandla Department of Obstetrics and Gynaecology, IMU health Care, Associate Dean Academic affairs, International Medical University, 126, Jln Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur, Malaysia
  • Krishna Kumar Department of Obstetrics and Gynaecology, Fetal Medicine Specialist, Hospital Tuanku Jaafar, Jalan Rasah, Seremban, Malaysia
  • Akshatha Daniel West Middlesex University Hospital, Twickenham Rd, Isleworth, United Kingdom

DOI:

https://doi.org/10.18203/2349-2902.isj20240752

Keywords:

Cesarean section, Scar pregnancy, Methotrexate, Serum β-hCG

Abstract

Cesarean scar pregnancy is a rare type of ectopic pregnancy but potentially life threatening. The incidence of this ectopic pregnancy continues to rise due to global increase in cesarean sections rates as well as the diagnosis with wide use of transvaginal ultrasound. Delay or wrong diagnosis may result to uterine rupture and life-threatening bleeding with potential maternal morbidity and mortality.  Endo-vaginal ultrasound has a reported sensitivity of 85-90% for detection. In difficult cases, magnetic resonance imaging is often useful as second line imaging. Treatment may be ranging from conservative to medical therapy or surgery. We present a series of three illustrative cases successfully managed with medical management and sequential treatment of medical and surgical management. We discuss diagnostic challenges and review of literature on updates on management strategies.

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Published

2024-03-27

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Section

Case Series