ABSTRACT

Ectopic pregnancy in a previous cesarean (hysterotomy) scar occurs in about 1 in 2000 pregnancies and accounts for 6 percent of ectopic pregnancies among women with a prior cesarean delivery. Adenomyosis, in vitro fertilization, previous dilation and curettage, and manual removal of the placenta are purported risk factors. In symptomatic patients, the clinical presentation ranges from vaginal bleeding with or without pain to uterine rupture and hypovolemic shock. The diagnosis is made by sonographically visualizing an enlarged hysterotomy scar with an embedded mass. Differential diagnosis includes spontaneous abortion, cervical ectopic pregnancy and placenta accreta. Cesarean scar pregnancy is rare and there is no complete consensus on the first choice treatment because most of them are presented as case reports in the literature. A successful treatment of cesarean scar pregnancy by placing balloon catheter in the lower segment after dilatation and curettage is presented here.