Successful term pregnancy after treatment of a cesarean scar ectopic gestation by endoscopic technique and conservative therapy.

OBJECTIVE

To describe a case of cesarean scar pregnancy treated successfully by endoscopic technique and medical therapy.

DESIGN

Case report.

SETTING

State general hospital in a major city.

PATIENT(S): A 32-year-old woman with two cesarean sections and a recent curettage presented with ectopic cesarean scar pregnancy.

INTERVENTION(S): Transvaginal ultrasound and hysteroscopy were used for diagnosis, and conservative therapy with methotrexate and hysteroscopy to treat the patient.

MAIN OUTCOME MEASURE(S): Modified hysteroscopic technique and outcome.

RESULT(S): Sonography and hysteroscopy revealed the presence of a gestational sac in the lower segment of the uterus in a patient with a cesarean section scar. She was successfully treated with systemic methotrexate and aspiration of the sac and local methotrexate injection under endoscopic control.

CONCLUSION(S): Endoscopic intervention combined with medical treatment can result in a good therapeutic outcome with preservation of fertility in early ectopic cesarean scar pregnancy.