Caesarean scar pregnancy: hysterotomy is rapid and safe management option

Mohamed Ali Abdelkader1, Reham Fouad, Amr Hosny Gebril

  • 1Department of Obstetrics and Gynecology, Cairo University, 28 al arkam ibn abi al arkam street, Al meraj, al maadi, Cairo, Egypt.

Caesarean scar pregnancy (CSP) is implantation of the gestational sac within the hysterotomy scar. Ultrasound is the main diagnostic tool. Early diagnosis and termination of pregnancy is crucial to avoid the risk of uterine rupture. The termination modalities available are dilatation and curettage, methotrexate therapy, hysteroscopy, uterine artery embolization and laparotomy. We present a case of undisturbed CSP which presented at 6 weeks + 6 days gestation. Our management was termination of pregnancy by exploratory laparotomy and hysterotomy for excision of the mass. The postoperative period was uneventful and there was rapid decline of beta human chorionic gonadotrophin to the normal level.

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