CAESAREAN SCAR PREGNANCY - A CLINICAL DILEMMA

Caesarean scar pregnancy is a rare entity . The diagnosis and treatment of this unusual implantation site presents both diagnostic and therapeutic dilemmas. There is no consensus of management for these pregnancies however, prior reports have suggested best results using either combination methotrexate therapy or surgical excision. The proper management of patients with caesarean scar ectopic pregnancies is a challenge due to the rare occurrence of the condition. We present a case of 30 year old G3P1L1A1,previous LSCS at 7 weeks 3 days of gestation referred with an USG finding of failed pregnancy implanted in the lower uterine segment which was managed medically after bilateral uterine artery embolisation and showed falling beta hcg levels. Laparotomy and excision was done anticipating rupture and to avoid further complications. The management of this condition should be individualised. In patients who are haemodynamically stable and have not completed their family conservative management should be given preference .The only disadvantage is the long period of follow up which needs patience and utmost vigilance.