Cesarean Scar Pregnancy: Imaging and Treatment with Conservative Surgery

Background: Pregnancy in a cesarean scar represents a rare type of secondary abdominal pregnancy. Early diagnosis can be challenging and optimal treatment is unknown. Case: A 21-year-old woman presented for an abortion at 8 weeks’ gestation. A cesarean delivery had been performed 5 months earlier. Suspecting a cervical pregnancy, her physician referred her to us, and an 8-week cesarean scar gestation was diagnosed and then confirmed by serial sonograms, cystoscopy, and magnetic resonance imaging. The patient elected pregnancy termination, which was accomplished by hysterotomy with uterine preservation followed by intramuscular methotrexate. Conclusion: We report a case of cesarean scar pregnancy treated surgically with uterine preservation. This approach should be considered when cesarean scar ectopic pregnancy is diagnosed.