Caeserean Scar Ectopic Pregnancy –Series of 10 Cases

Caeserean scar ectopic pregnancy (CSEP) is the rarest form of ectopic pregnancy withincidence of 1 in 2000 pregnancies. It requires high degree of suspicion and if notdiagnosed and managed early, can result in maternal morbidity and mortality. Due torise in rate of caesarean sections worldwide, therehas resulted anincrease in rate ofcaesarean scar ectopic pregnancies. Widespread availability of ultrasound services hashelped in early diagnosis and timely management. Here we present 10 cases ofCaesarean scar ectopic pregnancies that we have managed over period of 5 years(2018- 2023) in our tertiary care hospital. All cases were diagnosed by eithertransvaginal scan or transabdominal scan done at our hospital or done outside and thenreferred to us for management. There are different management options for caesareanscar ectopic pregnancy ranging from conservative to surgical treatment. Medicaltherapy is by using Inj Methotrexate 1mg /kg body weight intramuscular. Surgicaltreatment includes ultrasound guided suction evacuation, laparotomy, or laparoscopicexcision of scar ectopic. Since the entity is rare, presentations vary, there is no fixedprotocol of management of this condition. Patient may be benefited by surgery orsometimes medical management or there may be a combination of medical and surgicalmanagement. Traditionally laparotomy was done for removal of scar ectopic, howeverwith advent of good ultrasound machines, wecould manage most cases usingultrasound guided suction evacuation alone. Very few cases required medicalmanagement and laparotomyhad to be done in two cases