Objective: To describe a case of cesarean scar pregnancy treated successfully by endoscopic technique and medical therapy.
Design: Case report.
Setting: State general hospital in a major city.
Patient(s): A 32-year-old woman with two cesarean sections and a recent curettage presented with ectopic cesarean scar pregnancy.
Intervention(s): Transvaginal ultrasound and hysteroscopy were used for diagnosis, and conservative therapy with methotrexate and hysteroscopy to treat the patient.
Main outcome measure(s): Modified hysteroscopic technique and outcome.
Result(s): Sonography and hysteroscopy revealed the presence of a gestational sac in the lower segment of the uterus in a patient with a cesarean section scar. She was successfully treated with systemic methotrexate and aspiration of the sac and local methotrexate injection under endoscopic control.
Conclusion(s): Endoscopic intervention combined with medical treatment can result in a good therapeutic outcome with preservation of fertility in early ectopic cesarean scar pregnancy.