Cesarean scar pregnancy (CSP) successfully treated with dilatation and curettage after failed local methotrexate treatment: A case report and updated mini-review

Background: Caesarean Scar Pregnancy (CSP) is a very rare form of an abnormal pregnancy that implants in a Cesarean section scar. The incidence is mainly increasing due to increasing number of Cesarean sections. This condition is associated with substantial morbidity and even mortality. Case presentation: Because of its rarity, currently, there is no consensus on the preferred mode of treatment or follow up of CSP. Herein we report our experience with a case of first trimester CSP which was successfully managed with dilatation, evacuation and curettage (D&C), under ultrasound guidance, after failed local Methotrexate (MTX) treatment. Mini review: We included an updated mini review of literature targeted for such lines of treatment (local MTX and D&C). The first authoritative recommendations on the CSP, by the Society for MaternalFetal Medicine, are summarized. Conclusion: Operative intervention as D&C to treat CSP after failed local MTX treatment is a viable option characterized by technical simplicity efficacy and avoidable or controllable intra-operative complications. This is particularly justifiable if other advanced therapeutic techniques are not available.