Pregnancy in a Cesarean Section: A Case Study

Caesarean scar pregnancy is rare and delay in diagnosis and treatment is associated with maternal complications, but diagnostic and treatment methods are under investigation due to its rare and there is not standard protocol for manage Caesarean scar pregnancy. The purpose of this case report study is to provide early diagnosis and treatment Caesarean scar pregnancy.

A 34-year-old woman, gravid 2, gestational age of 8 weeks and 3 days, and history of one cesarean section with a complaint of spotting and severe abdominal pain went to the hospital. Beta-human chorionic gonadotropin was reported (β-hCG), 5600 mIU / ml. In a transvaginal ultrasonography of a gestational sac containing internal echoes without embryonic pole was seen in the previous cesarean section and in color doppler of blood flow around the gestational sac. The patient was followed for 3 days the ectopic pregnancy spontaneous abortion or to reduce the size of the gestational sac in the hospital, but dilatation and suction curettage and hysteroscopy resection was performed due to increased β-hCG. Twenty-four hours after treatment, the first β-hCG, 191 mIU / ml was reported, the next evaluation was carried out in two stages with 48-hour intervals and the rate of β-hCG had a decreasing trend. Then, one week later, it was reexamined and the rate of β-hCG was reached to 30 mIU / ml. After eleven days of follow up due to the decrease of β-hCG, the follow-up was stopped.

In the present patient, the caesarean scar pregnancy was diagnosed with transvaginal ultrasonography in the early stages and proper treatment with dilatation and suction curettage and hysteroscopy resection was performed.