Mid-trimester cesarean scar pregnancy: a case report

Mary Louise Fowler,Shruthi Mahalingaiah,Michael Muto,Sarah Little

doi:10.1186/s40738-021-00103-9

Abstract

BackgroundThis article reports a unique case of cesarean scar pregnancy, demonstrating importance of early management and diagnosis.Case presentationA 30-year-old pregnant woman with prior history of two cesarean sections found to have cesarean scar pregnancy at approximately 13 weeks’ gestation and underwent a gravid hysterectomy.ConclusionsWhile rare, cesarean scar pregnancies should be considered on the differential diagnosis of any pregnant patient with history of cesarean section who presents in early pregnancy with vaginal bleeding and/or cramping. Given the increased rates of cesarean sections in the times of COVID-19, one may anticipate seeing more cases of cesarean scar pregnancies.

Highlights

This article reports a unique case of cesarean scar pregnancy, demonstrating importance of early management and diagnosis
In the times of the COVID pandemic, there has been noted to be an increase in cesarean deliveries, with one study noting that 93% of COVID-positive pregnant patients underwent a cesarean section, and 61% of these had the procedure performed due to concern about effects of COVID-19 on the pregnancy [2]
We present a case of Cesarean scar pregnancy (CSP) diagnosed in the second trimester and subsequent management

Summary

Introduction

This article reports a unique case of cesarean scar pregnancy, demonstrating importance of early management and diagnosis. These pregnancies can result in significant morbidity and mortality, including uterine rupture and may require emergent hysterectomy if not recognized early. * Correspondence: shruthi@hsph.harvard.edu 4Division of Reproductive Endocrinology and Infertility (REI), Massachusetts General Hospital, Yawkey Center – 10th Floor, Boston, MA 02114, USA 5Department of Environmental Health, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Building 1, 14th Floor, Boston, MA 02115, USA Full list of author information is available at the end of the article diagnosis has improved with the technological improvement in ultrasonography, optimal management of CSP is unknown and a standard of care has not been identified.

Results

Conclusion