Presentation
Amenorrhea for 7 weeks, and intermittent vaginal spotting for few days. Patient had a positive urine pregnancy test. Obstetric history was G2P1L1, with previous cesarean delivery.
Patient Data
A transvaginal ultrasound examination shows a retroverted uterus with the presence of a gestational sac positioned on the anterior part of the lower uterine section, corresponding to the prior cesarean scar region. The myometrial thickness measures 0.24 cm, meeting the criteria of a cesarian scar ectopic pregnancy 1.
The uterine cavity and the cervical canal were empty. The cervical canal is filled with a thin streak of fluid extending into the scar region.
Case Discussion
The preceding article depicts an instance of cesarean scar ectopic pregnancy. Scar ectopic pregnancy is an uncommon cause of ectopic pregnancy, accounting for around one out of every 2000 pregnancies 2.
The ultrasound diagnosis of an ectopic scar pregnancy includes the following criteria 1:
the uterus is empty and the endometrial lining is readily evident
the cervical canal is empty
presence of the gestational sac at the anterior lower uterine segment corresponding to the previous cesarean scar site
the myometrium connecting the gestational sac and the bladder is thin or nonexistent (typically, the myometrial thickness is less than 5 millimeter)
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