Caesarean scar pregnancy: diagnostic dilemma

Abstract

Caesarean scar pregnancy is a rare but life-threatening type of ectopic pregnancy if not accurately diagnosed on time. With increasing caesarean section rates, caesarean scar pregnancy is bound to increase. In this report, we describe a case of a woman with pregnancy developed within previous caesarean scar (Type-I, cervico-isthmic type) and successfully treated with medical management. The diagnosis of pregnancy on caesarean scar is easily made by transvaginal ultrasound and color Doppler flux. Unfortunately in some cases, as well as in our case, the diagnosis was not simple. Infact, in our case twin gestation was the initial diagnosis, by serial Beta HCG values and transvaginal ultrasound by an expert sonologist the diagnosis was made. We were successful in treating this rare form of ectopic pregnancy without any maternal morbidity with medical management alone. We report this case to highlight the importance of knowing the ultrasound criteria to diagnose Caesarean scar pregnancy, so that catastrophies can be prevented.