Successful pregnancy located in a uterine cesarean scar: A case report

Abstract

Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy. Because CSP carries a high risk of uterine rupture and life-threatening bleeding, the pregnancy should be terminated upon confirmation of diagnosis. There have been few reports of CSP with successful delivery. We present a case of CSP under expectant management, with delivery via planned cesarean section at 35 weeks of gestation. This report suggests that successful pregnancy outcome can be achieved in some women with uterine cesarean scar, but further analysis and additional studies are required in order to describe the optimal protocol of expectant management in CSP.

Keywords: Cesarean scar pregnancy; Ectopic pregnancy; Expectant management; Hysterectomy; Placental invasion into myometrium.

Fig. 1

Ultrasonographic image at 12 weeks and 5 days of gestation shows the gestational sac embedded within the anterior lower segment of the cesarean scar, and overswelling of multiple vessels between the placenta and the bladder.

Fig. 2

MRI image at 14 weeks and 1 day of gestation shows the placenta penetrating into the muscle of the bladder wall.

Fig. 3

Cesarean section in a woman with cesarean scar pregnancy. Placental invasion into the myometrium was observed, and hysterectomy was performed after removing the neonate.