Scar Pregnancy a Diagnostic Conundrum: A Case Report

JNMA J Nepal Med Assoc. 2021 Mar 31;59(235):288-291. doi: 10.31729/jnma.5202.

Abstract

Cesarean scar pregnancy is a rare form of ectopic pregnancy which may lead to uterine rupture and catastrophic hemorrhage. We report a case of cesarean scar pregnancy in a 35-year-old female with the past history of cesarean section presented with complaints of amenorrhoea for 6 weeks and non-specific pain. Two Transvaginal sonography was done 48 hours apart which suggested a cesarean scar pregnancy in one and cervical pregnancy on the other. Magnetic Resonace Imaging showed a well-defined cystic lesion of (21x19)mm2 embedded within the previous cesarean scar which confirmed the diagnosis of cesarean scar pregnancy. Laparotomy unveiled uterus around 6 weeks size and a (3x3)cm2 bulge was noted at the site of previous scar in lower uterine segment, where a small incision was given and the gestational sac was removed following which the uterine incision was closed with 2-0 polyglactin suture. High index of suspicion and prompt diagnosis is ofparamount for reducing morbidity and mortality.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cesarean Section / adverse effects
  • Cicatrix / diagnosis
  • Cicatrix / pathology
  • Female
  • Humans
  • Hysterotomy
  • Pregnancy
  • Pregnancy, Ectopic* / diagnostic imaging
  • Pregnancy, Ectopic* / surgery
  • Uterine Rupture* / diagnosis
  • Uterine Rupture* / etiology
  • Uterine Rupture* / surgery