RCOG World Congress 2025

CESAREAN SCAR PREGNANCY DIAGNOSTIC CHALLENGES AND MANAGEMENT OPTIONS : A CASE REPORT

TEHMINA KANWAL, QURAT-UL-AIN ,NAUSHIN FAROOQ,LUBNA BASHIR, SABEEN ASLAM, SADIA ZIA

OBSTERICS & GYNAECOLOGY ,FEDERAL GOVERNMENT POLYCLINIC (PGMI), ISLAMABAD ,PAKISTAN

CASE SUMMARY OF CESAREAN SCAR PREGNANCY

PATIENT XYZ , 32 YEARS OLD ,G3P2 ,PREVIOUS 2 LSCS PRESENTED THROUGH OPD AT GESTATIONAL AMENORRHEA OF TWO AND HALF MONTHS WITH COMPLAINS OF PV BLEEDING FOR ONE DAY .SHE WAS MARRIED FOR 7 YEARS WITH LCB 2 YEAR

ON EXAMINATION , VITALLY STABLE , ABDOMEN WAS SOFT ,NON TENDER, SYSTEMIC EXAMINATION UNREMARKABLE

USG FROM RADIOLOGIST REVEALED A SINGLE ALIVE FOETUS OF 11+ WEEKS IN A WELL DEFINED OVAL GESTATIONAL SAC IN LOWER UTERINE SEGMENT INSEPRABLE FROM THE SITE OF PREVIOUS SCAR WITH MYOMETRIUM THICKNESS 1.8mm .DIAGNOSIS OF CS PREGNANCY

•PATIENT WAS ADMITTED , HER BASELINE IVESTIGATIONS DONE ,

BHCG DONE WAS 61402 mIU/ML.

•AFTER COUNSELLING MEDICAL MANAGEMENT STARTED.

•.INJECTION METHOTREXATE GIVEN ON 12-1-24 AND REPEATED ON 16-1-24.

•PLAN WAS MADE FOR LAPAROTOMY AND REMOVAL OF CESAREAN SCAR PREGNANCY.

•HER LAPAROTOMY WAS DONE ON 19-1-24.

•PEROPERATIVELY SHE HAD DIDELPHOUS UTERUS WITH LARGE HORN HAVING SCAR ECTOPIC PREGNANCY IN LOWER LEFT SITE. OTHER HORN RUDIMENTARY WITH ONE TUBE AND OVARY ATTACHED WITH EACH HORN.

•DEFICIENT MYOMETRIUM AT SCAR PREGNANCY SITE ,BABY AND PLACENTA WAS REMOVED ,UTERUS CLOSED ,HAEMOSTATIS SECURED.

•POST OPERATIVE PERIOD UNEVENT FUL DISCHARGED HOME ON 3RD POST OPERATIVE DAY WITH FOLLOW UP ADVISED.

RCOG World Congress 2025

Cesarean Scar Pregnancy Diagnostic Challenges And Management Options : A case Report

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