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Abstract

Background: This rare but devastating type of ectopic implantation in which the pregnancy takes place within the myometrium at the location of a previous lower-segment cesarean section scar is called scar ectopic pregnancy, and especially cesarean scar ectopic pregnancy (CSEP). The increasing number of cesarean sections performed all over the world has been followed by an increase in this condition, which poses great diagnostic and therapeutic difficulties to obstetricians.
Objective: This series of cases will attempt to describe the range of presentations of cesarean scar ectopic pregnancies, describe the intricacies of diagnosing the condition, and review the varied management options varying from conservative medical treatment to surgery.
Methods and Cases: This report details eight cases of ectopic pregnancy in the cesarean scar managed at the authors' center. Each case was unique regarding gestational age, clinical stability, diagnostic workup, and definitive treatment. The approaches employed included medical management (methotrexate, ultrasound-guided potassium chloride injection) and surgical methods (scar excision, hysterectomy).
Conclusion: The early detection of ectopic implantation might be considered dangerous, if any suspicion might enter into the minds of the evaluators. Ultimately the treatment route must depend upon such factors as hemodynamic stability, the wish for subsequent fertility of the woman, gestational age, and what resources are available locally. This series of cases describes the significance of early clinical identification of red flag signs, proper imaging techniques, and prompt management aimed at minimizing morbidity and preserving fertility whenever it can be.