Ectopic pregnancies in caesarean section scars: 5 years experience.

Area of Science:

• Reproductive Medicine
• Obstetrics & Gynecology
• Medical Imaging

Background:

• Ectopic pregnancy in a Caesarean scar (CSEP) is a rare but serious complication.
• Early diagnosis and management are critical for patient outcomes and fertility preservation.

Purpose of the Study:

• To evaluate a 5-year experience in the diagnosis and treatment of Caesarean scar ectopic pregnancy (CSEP).

Main Methods:

• Retrospective analysis of 21 women diagnosed with CSEP between 2012 and 2016.
• Diagnosis confirmed via trans-vaginal color Doppler ultrasonography and MRI.
• Treatment included systemic methotrexate or trans-cervical aspiration.

Main Results:

• Vaginal bleeding and abdominal pain were common symptoms, but 47.6% were asymptomatic.
• Ultrasound and MRI confirmed gestational sac within the Caesarean scar with thinned myometrium.
• Methotrexate treatment resulted in no complications, while aspiration led to bleeding in all cases, with one hysterectomy and one uterine rupture.

Conclusions:

• Early imaging diagnosis and effective treatment of CSEP are vital.
• Minimizing maternal complications and preserving future fertility are key goals.
• Systemic methotrexate is a safe and effective treatment option for CSEP.