Surgical management of cesarean scar ectopic pregnancy: hysterotomy by transvaginal approach

Objective To report on the surgical management of a cesarean scar ectopic pregnancy (CSEP) by transvaginal hysterotomy. Design Case report. Setting University hospital. Patient(s) A 29-year-old woman, with previous cesarean delivery, presenting with vaginal bleeding, was transfered to our hospital at 5 weeks 4 days of gestation. Transvaginal ultrasonography confirmed the diagnosis of CSEP. Intervention(s) Hysterotomy by transvaginal approach of the CSEP. Main Outcome Measure(s) During the operation, there were no significant complications. Postoperative ultrasonography showed complete disappearance of the ectopic gestational sac. Result(s) Good recovery of the patient and return of normal menstruation. Conclusion(s) Surgical removal of the ectopic mass by transvaginal hysterotomy may be a less invasive approach in cases of CSEP. This case report offers an alternative treatment to other proposed methods for CSEP, with a short operative time and minimum blood loss.