Embryo Implantation in the Region of a Previous Caesarean Section Scar and Scar Dehiscence in Second Trimester: A Rare Case Report.

Abstract

The first case of a Caesarean scar site ectopic pregnancy was reported in 1978 [1]. Implantation of a pregnancy within a caesarean fibrous tissue scar is considered to be the rarest form of ectopic pregnancy and a life-threatening condition. This is because of the very high risk of uterine rupture and the maternal complications related to it. The most probable mechanism that can explain scar implantation is that there is invasion of the myometrium through a microtubular tract between the caesarean section scar and the endometrial canal. A recent case series estimates an incidence of 1:2226 of all pregnancies, with a rate of 0.15 % in women with a previous caesarean section and a rate of 6.1 % of all ectopic pregnancies in women who had at least one caesarean delivery [2].Although expectant and medical management have been reported in early pregnancy, termination of a caesarean scar pregnancy by laparotomy and hysterotomy, with repair of the accompanying uterine scar dehiscence, may be the best treatment option in later weeks of pregnancy.