Caesarean section scar pregnancy: expectant management with favourable outcome of an acute presentation

A woman in her early 40s, who had two previous caesarean sections, at 10-week period of amenorrhoea presented to our hospital gynaecology clinic.A caesarean scar pregnancy (CSP) was diagnosed after performing a transvaginal scan.The diagnosis was explained to the patient, and the patient opted for expectant management.She presented to the emergency department with severe abdominal pain and vaginal bleeding after 4 days.A transvaginal scan revealed a CSP with a fetal pole and heartbeat.Since the cervical os was opened, a successful suction curettage was performed. Beta hCG became undetectable 11 days after curettage.This case demonstrates the current knowledge of the application of transvaginal scanning for managing the presentations of CSP, and the correct application of minimally invasive tailor-made surgical procedures will provide cost-effective and safer outcomes for individual patients.