Cesarean Scar Pregnancy: A Case Report

Due to a significant increase in cesarean section, cesarean scar pregnancy has increased dramatically which can endanger the life of the mother if early diagnose and treatment is not timely performed. Severe vaginal bleeding can be mentioned as one of the symptoms which its definite diagnosis could be made by ultrasound. Case report: The patient was a 36-year-old woman with a history of a normal vaginal delivery and a caesarean section at 10 weeks and 5 days of gestational age who was admitted with chief complaints of severe vaginal bleeding. Ultrasound examination detected no fetal heart rate, and then serum of the oxytocin was infused. After two episodes of bleeding, the patient was transferred to the operating room for curettage. During performing curettage, a notch was observed in inferior anterior part of uterus simultaneously with much vaginal bleeding so as the patient was regarded hemodynamically unstable, and thus the hysterectomy was taken. After the uterine incision in the Department of Pathology, pregnancy in previous cesarean scar was detected. Two days later, the patient was discharged with good general condition receiving some medication advice and necessary recommendations.

Previous cesarean scar pregnancy if not detected early can be associated with high morbidity and mortality. Therefore, the possibility of this pregnancy should be considered in pregnant women with uterine bleeding, abdominal pain as well as a history of cesarean section. It should be noted that after previous cesarean scar pregnancy was definitely diagnosed via ultrasound examination, treatment necessitates to be started utilizing methotrexate to ensure the future fertility of the mother.