Management of an 11-week cesarean scar pregnancy

Abstract

Introduction: cesarean scar pregnancy is a lifethreatening condition, especially in the advanced gestational age. Optimal management has not yet been established because this is a rare condition. case report: A 30-year-old female, with a previous cesarean, diagnosed with a viable cesarean scar pregnancy with 11 weeks of gestation. successful termination of cesarean scar pregnancy was achieved with systemic and local (ultrasoundguided) methotrexate administration with subsequent dilatation and evacuation, under ultrasound guidance, in a two- stage procedure: rupture of the amniotic sac with partial removal of the fetus and one week later total evacuation of uterine content, with satisfactory hemostasis. conclusion: cesarean scar pregnancy is associated with a high morbidity and adverse consequences for future fertility. there is no optimal management established, because of the rarity of the condition. We present a case of successful termination of an advanced first trimester cesarean scar pregnancy.