Case report on caesarean scar ectopic pregnancy

Abstract

A 42-year-old woman presented with symptoms of vaginal bleeding and lower abdominal pain. The patient was diagnosed with a Caesarean Scar Ectopic (CSP) pregnancy, which is a type of ectopic pregnancy (EP) that occurs in women who have undergone previous Caesarean sections. EP is the leading cause of maternal morbidity and/or mortality during the first trimester, with a prevalence of 11 per 1000 pregnancies in the UK. The incidence of CSP has increased globally as the incidence of Caesarean sections has risen. Diagnosis of EP is undertaken by carrying out imaging tests, which confirm the presence of a gestational sac outside the endometrial cavity. The text also discusses the risk factors associated with the occurrence of EP, including age above 35 years, history of endometriosis, pelvic inflammatory disease, cigarette smoking, use of progesterone-only contraception, previous EP, and previous pelvic surgery. The patient was administered systemic intramuscular methotrexate, but the hCG levels continued to rise, and she subsequently underwent administration of gestational sac methotrexate under transvaginal ultrasound guidance. The hCG levels down trended following the procedure, and the patient was discharged home within 48 hours, with no complications reported.