Recurrent Ectopic Pregnancy in a Cesarean Scar

Abstract

Ectopic pregnancy in a cesarean scar is an important diagnosis to consider in a woman who has had a history of cesarean delivery and whose early ultrasonography shows a thin, lower uterine segment or a low implantation site. If the diagnosis is not clear on initial ultrasound examination, the patient should be followed up with serial ultrasound examinations. Once recognized, patients with this complication may be treated either surgically or medically as indicated by the clinical situation.

Reproductive outcomes following cesarean scar pregnancy – a case series and review of the literature

“…Despite repair of the uterine scar defect, this did not always result in live-births [13,19]. Furthermore, recurrence of CSP occurred even after surgical reconstruction of the cesarean scar defect [14]. There were 3 patients in our study who underwent laparotomy uterinescar defect repair.…”

Diagnosis and management of cervical ectopic pregnancy

“…In 2002, the following guidelines were laid down for ultrasound diagnosis of an ectopic pregnancy within a cesarean scar:[8](a) an empty uterine cavity and cervical canal, (b) development of the gestational sac in the anterior portion of the lower uterine segment and (c) absence of a healthy myometrium between the bladder and the gestational sac. Although her history included IUI, which is a risk factor for CP,[9] and we could rule out cervical abortion due to the presence of cardiac activity, it was difficult to exclude the possibility of uterine scar pregnancy because of previous LSCS.…”

Methotrexate‐based bilateral uterine arterial chemoembolization for treatment of cesarean scar pregnancy

“…However, this method has a long therapeutic course with a high risk of massive hemorrhage which could result in hysterectomy. Moreover, major side effects may occur if the medications are systemically administered (2).…”