A C scar ectopic pregnancy (CSEP) is the rarest form of ectopic pregnancy (pregnancy outside of the uterus) in which the embryo implants over a previous C section scar. Some risk factors have been suggested to contribute to this condition, such as hysterotomy, uterine manipulation and in vitro fertilization.
Presentation
In general, the classic triad of an ectopic pregnancy is abdominal/pelvic pain, vaginal bleeding and a painful mass. Case reports of patients with CSEP have been described. Patients usually present with history of amenorrhea (missed menstruation), lower abdominal pain, abnormal vaginal bleeding.
CSEP could also be detected incidentally on routine first-trimester pregnancy ultrasound.
Detection
After the patient learns that she’s pregnant through a positive pregnancy test, her doctor will schedule an ultrasound for her which would visualize the implantation site of the embryo.
CSEP is considered a life-threatening emergency because it increases the risk of rupture of the uterine wall.
Management
When detected early, CSEP could be treated conservatively through dilation and curettage or methotrexate. Management could sometimes require surgical removal of the pregnancy and repair of the uterine wall.
