Expectant Management Challenge in Cesarean Scar Pregnancy: A Case Report

Cesarean scars in pregnancy have become a worrisome obstetric problem. Furthermore, given the challenge of diagnosis in cases of low suspicion in the initial prenatal sonographic screening, there is still debate over the standard of management. According to rare reported cases, the most acceptable recommendation is still termination of pregnancy to decrease the chance of further maternal dreadful complications. A case of twin pregnancy had been terminated at gestational age of 34 weeks with a history of diagnosis of cesarean scar pregnancy. Since pregnancy at the site of a previous cesarean section is very rare, but due to the complications of this type of pregnancy, choosing a suitable clinical approach for these patients is desirable. This type of pregnancy can increase the value of antenatal care if it can be continued until the fetus is viable and its complications, including placenta accreta and bleeding, are managed.