Laparoscopic management of cesarean scar pregnancy with isthmocele repair using Rahman’s classification and surgical technique: a case report

Hafeez Rahman; Sonia Farhan; Ayesha Taniya

doi:10.18203/2320-1770.ijrcog20260211

Authors

Hafeez Rahman Department of Obstetrics and Gynecology, Sunrise Hospital, Kakkanad, Kochi, Kerala, India
Sonia Farhan Department of Obstetrics and Gynecology, Sunrise Hospital, Kakkanad, Kochi, Kerala, India
Ayesha Taniya Department of Obstetrics and Gynecology, Sunrise Hospital, Kakkanad, Kochi, Kerala, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20260211

Keywords:

Caesarean scar ectopic, Isthmocele, Rahman’s technique, Uterine niche, Uterine scar defect

Abstract

The global increase in caesarean section (CS) rates has resulted in a higher incidence of caesarean scar-related complications such as uterine niche, isthmocele, and caesarean scar pregnancy (CSP). Existing classification systems focus on when to operate rather than how to perform precise surgical repair. We present a case of a 32-year-old woman with a 5-week caesarean scar pregnancy associated with a large isthmocele, diagnosed by transvaginal ultrasound showing a 20×15 mm scar defect with a myometrial thickness of 2 mm. She underwent laparoscopic evacuation of the scar pregnancy followed by isthmocele repair based on Rahman’s classification and surgical technique. Rahman's classification and surgical technique provide a structured approach that addresses both anatomical defects and abnormal mucosa. While this case shows a positive clinical outcome, more validation from deeper research is required before definitive conclusions on recurrence reduction or fertility outcomes can be drawn.

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