Affiliation:
1. Department of Obstetric and Gynecology, Nowrosjee Wadia Maternity Hospital, Parel, Mumbai, Maharashtra, India,
Abstract
Cesarean scar (C scar) ectopic pregnancy is complex pathological condition and occasionally can be life-threatening due to complications. The rise in the incidence is due to the rise in cesarean and early pregnancy sonography. For proper diagnosis, transvaginal sonography with color Doppler is far superior. Multidisciplinary approach with counseling is needed to individualize treatment as there are various modalities of management. This case report is of C scar ectopic pregnancy referred for further management. After reconfirming the diagnosis, systemic medical therapy was given. Following rise of beta-human chorionic gonadotropin (beta HCG), intralesional instillation of methotrexate was done. Follow-up ultrasonography revealed no fetal pole without any vascularity and declining beta-HCG. However, after 7 weeks, empty sac was still present, and hence, dilatation with evacuation was done. Early gestational termination is preferable with disruption of trophoblastic invasion, before surgical intervention to avoid complications.