Cesarean scar ectopic pregnancy: Reports of two cases
Cesarean scar ectopic pregnancy (CSEP) is a rare but increasingly recognized form of ectopic pregnancy, in which the blastocyst implants within the myometrial tissue at the site of a previous cesarean section scar. The global rise in cesarean delivery rates has led to a corresponding increase in the...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Ibrahim Medical College
2025-07-01
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| Series: | IMC Journal of Medical Science |
| Subjects: | |
| Online Access: | https://www.imcjms.com/registration/journal_full_text/569# |
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| Summary: | Cesarean scar ectopic pregnancy (CSEP) is a rare but increasingly recognized form of ectopic pregnancy, in which the blastocyst implants within the myometrial tissue at the site of a previous cesarean section scar. The global rise in cesarean delivery rates has led to a corresponding increase in the prevalence of CSEP, currently estimated at approximately 1 in 1,800 to 1 in 2,226 pregnancies. This condition poses a significant risk of life-threatening complications, including uterine rupture, massive hemorrhage, and potential loss of fertility if not diagnosed and managed promptly.
We present two clinically distinct cases of CSEP managed at a tertiary care hospital in Dhaka. Both patients had a history of prior cesarean delivery and presented with different gestational ages and clinical manifestations. The first case involved a viable 8-week pregnancy implanted in the cesarean scar, diagnosed via transvaginal ultrasonography and managed surgically with hysterotomy. The second case presented as a missed abortion at 22 weeks and was later identified as an advanced cesarean scar ectopic pregnancy, requiring emergency laparotomy due to uterine wall protrusion and fetal demise.
These cases underscore the importance of early diagnosis through imaging and individualized treatment planning based on the gestational age, viability, patient stability, and fertility desires. Prompt recognition and appropriate management are critical in minimizing maternal morbidity and optimizing outcomes.
July 2025; Vol. 19(2):004. DOI: https://doi.org/10.55010/imcjms.19.013
*Correspondence: Nurun Naher, Obstetrics & Gynaecology Department, BIRDEM General Hospital, Dhaka, Bangladesh. E-mail: nayanbirdem@gmail.com.
© 2025 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License(CC BY 4.0). |
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| ISSN: | 2519-1721 2519-1586 |