A misdiagnosed cesarean scar pregnancy: a case report

Abstract

A caesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy in which gestational sac is Implanted inside the previous caesarean scar. It is a life-threatening form of abnormal Implantation of embryo within the myometrium and fibrous tissue of the previous scar following caesarean section. Transvaginal sonography (TVS) is the gold standard for diagnosis of CSP. If CSP is diagnosed early and correctly by TVS then patient outcome is better. One third of the cases are misdiagnosed. A patient G2P1L1A0 with previous one caesarean section came with history of amenorrhea 3 months and, pain abdomen and spotting P/V since morning, she had an ultrasound report with her showing, 8 weeks of intra-uterine pregnancy with no cardiac activity. Impression was missed abortion. Patient was prepared for suction and evacuation under GA. During the procedure, patient started bleeding heavily, her vitals deteriorated, an emergency laparatomy was done and it was found to be a scar pregnancy. Scar was excised; the patient withstood the surgery well. Post-operative period was uneventful.