Successful Hysteroscopic Resection of Caesarean Scar Ectopic Pregnancy With Subsequent Intrauterine Pregnancy: A Case Report

A 36-year-old woman (G5P3A1) with two previous lower-segment caesarean sections presented with a positive pregnancy test and minimal vaginal bleeding. Transvaginal ultrasound demonstrated a six-week gestational sac implanted within the prior scar; initial serum beta human chorionic gonadotropin (β-hCG) was 7775 mIU/mL. After counselling, she elected fertility-preserving hysteroscopic resection. β-hCG level reached 24000 mIU/mL, operative hysteroscopy with bipolar loop excision of the gestational sac was performed uneventfully. β-hCG fell to 6095 mIU/mL on postoperative day one and was undetectable by week four. Six-week ultrasound confirmed complete scar resolution. Five months later the patient conceived spontaneously and progressed to a viable intrauterine pregnancy.