EC Gynaecology

Cesarean scar pregnancy (CSP) is a rare ectopic pregnancy, with potential risk for major maternal complications. Its incidence keeps on rising, parallel to the continuous increment in cesarean birth rates. This emerging problem calls for more clinical studies on the outcome of different treatment methods, in order to elaborate ideal management recommendations. To this end, we share the case of a CSP treated in our unit, which has required recourse to second line therapy after failure of medical treatment.

 Keywords: Cesarean Scar Pregnancy; Ectopic Pregnancy; Management

1. Sonia Asif., et al. “Caesarean scar pregnancy: diagnosis and management”. Obstetrics, Gynaecology and Reproductive Medicine10 (2021): 271-274.
2. Jurkovic D., et al. “First-trimester diagnosis and management of pregnancies implanted into the lower uterine segment Cesarean section scar”. Ultrasound in Obstetrics and Gynecology 3 (2003): 220-227.
3. Molloy BG., et al. “Delivery after caesarean section: review of 2176 consecutive cases”. British Medical Journal (Clinical Research Edition) 6588 (1987): 1645-1647.
4. Panaitescu AM., et al. “Diagnosis and management of cesarean scar pregnancy and placenta accreta spectrum: case series and review of the literature”. Journal of Ultrasound in Medicine 9 (2021): 1975-1986.
5. Nawroth F., et al. “Conservative treatment of ectopic pregnancy in a cesarean section scar with methotrexate: a case report”. European Journal of Obstetrics and Gynecology and Reproductive Biology 1 (2001): 135-137.
6. Maheux-Lacroix S., et al. “Cesarean scar pregnancies: a systematic review of treatment options”. Journal of Minimally Invasive Gynecology 6 (2017): 915-925.
7. Miller R., et al. “Society for maternal-fetal medicine (SMFM) Consult series #49: cesarean scar pregnancy”. American Journal of Obstetrics and Gynecology5 (2020): B2-B14.
8. Rotas MA., et al. “Cesarean scar ectopic pregnancies: etiology, diagnosis, and management”. Obstetrics and Gynecology6 (2006): 1373-1381.
9. Miller R., et al. “Society for maternal-fetal medicine consult series #63: Cesarean scar ectopic pregnancy”. American Journal of Obstetrics and Gynecology3 (2022): B9-B20.
10. Andrea Kaelin Agten., et al. “First-trimester cesarean scar pregnancy: a comparative analysis of treatment options from the international registry”. American Journal of Obstetrics and Gynecology6 (2024): 669.e1-669.e19.
11. Morcel K., et al. “Gestion de la grossesse ectopique dans la cicatrice de cesarienne”. Collège national des gynécologues et obstetriciens français.
12. Maymon R., et al. “Ectopic pregnancies in cesarean section scars: the 8-years experience of one medical center”. Human Reproduction2 (2004): 278-284.
13. Deans R and Jason Abbott. “Hysteroscopic management of cesarean scar ectopic pregnancy”. Fertility and Sterility6 (2010): 1735-1740.