Ectopic pregancy in a previous cesarean scar

Abstract

Ectopic pregnancies in the scar of previous cesarean section are an infrequent
pathology. They represent the rarest form of ectopic gestation and occur in 1 in
2.000 pregnancies. In recent decades there has been an increase in its incidence
related to the increase in the number of cesarean sections. Its inconsistent clinical
presentation may delay its diagnosis, so it requires a high degree of suspicion for its
identification. The diagnosis is mainly made with transvaginal ultrasound, by finding
of the gestational sac in the hysterotomy scar. The scarcity of cases reported in the
literature makes it impossible to standardize correct treatment. The insufficient
information available together with the potential serious complications make this
pathology a challenge for every specialist. We present a case of ectopic pregnancy
in the scar of a previous cesarean section which was diagnosed ultrasonographically
and resolved with medical treatment with methotrexate. The importance of followup,
both clinical and with ultrasound and βhCG levels until complete resolution, is
evident.