EP20.03: A molar pregnancy as a Caesarean scar pregnancy: a very rare case report

Ectopic pregnancy and molar pregnancy are not rare events. However, Caesarean scar pregnancy is a rare form of ectopic pregnancy and the combination of Caesarean scar pregnancy and molar pregnancy is an extremely rare event. only a small number of cases have been reported in the literature. this is the nineth case in the world. A 43-year-old woman with a history of obesity, hypertension, and previous ectopic pregnancy, vaginal delivery, and Caesarean sections, presented with persistent vaginal bleeding post-spontaneous abortion. Transvaginal ultrasonography revealed a suspicious 37.4mm*25.5mm hyperechogenic mass with cystic areas and abundant blood flow signals in the uterine isthmus, potentially involving the Caesarean scar, indicating a molar pregnancy. Endouterine aspiration under ultrasound guidance removed grape-like tissue and blood clots, followed by intrauterine tamponade for 24 hours. Despite stable hemodynamics post-procedure, she experienced significant vaginal bleeding six hours later, necessitating emergency hysterectomy due to unavailable uterine arterial embolization. Pathology confirmed a partial hydatidiform molar pregnancy in the uterine scar. The patient was discharged with hCG follow-up for six months per molar pregnancy protocols. Molar pregnancy on a scar remains an exceptional event. The diagnosis must be made by a good echography and the anatomopathological result. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.