CESAREAN SCAR ECTOPIC PREGNANCY- AN ENIGMA

Abstract

Cesarean section scar ectopic is a rarest form of abdominal ectopic pregnancy. It has a relation with increasing numbers of cesarean delivery and has an incidence of about 0.09% of all pregnancies nowadays. In this case a 27 years old woman had presented with amenorrhea, pain in lower abdomen and per vaginal bloody discharge. Her serum beta-HCG level was elevated. She was haemodynamically stable. No abnormalities were detected per abdominally, only bloody discharge was present on per speculum examination. Radiological ndings of G-sac like structure embedded in previous lower segment caesarean scar of uterus suggested of caesarean scar ectopic. Color Doppler had shown blood ow in scar decient area. In this case medical management with systemic methotrexate failed. Eventually surgical resection of the G-Sac with scar tissue was done by laparotomy followed by repair of the wound. Thus early diagnosis and management prevented further complications like uterine rupture, hysterectomy and even maternal death