Downloads: 1
Case Series | Obstetrics and Gynecology | Volume 15 Issue 7, July 2026 | Pages: 2267 - 2270 | India
Clinical Presentation, Ultrasound Characteristics, and Management Outcomes of Caesarean Scar Pregnancy: A 12-Case Series
Abstract: Background: Caesarean scar pregnancy (CSP) is an uncommon form of ectopic implantation associated with severe haemorrhage, uterine rupture, placenta accreta spectrum, and loss of fertility. Because presentation and available treatment options are heterogeneous, detailed institutional case series remain clinically informative. Methods: We reviewed 12 women diagnosed with CSP and recorded demographic characteristics, obstetric history, presenting symptoms, transvaginal ultrasound findings, serum beta-human chorionic gonadotropin (beta-hCG), haemoglobin, management, operative findings, transfusion, intensive care admission, and length of hospital stay. Data were summarised descriptively. Results: The mean age was 31.8 +/- 3.6 years. Seven women (58.3%) had vaginal bleeding, six (50.0%) had abdominal pain, and five (41.7%) were diagnosed incidentally. None presented with syncope, shock, abdominal tenderness, or sonographic haemoperitoneum. All had an empty uterine cavity and cervical canal with a gestational sac at the previous cesarean scar. Median gestational age was 6+4 weeks (range 5+3-9+5), median beta-hCG was 7,501 IU/L (range 207-111,505), fetal cardiac activity was present in 4 (33.3%), and median residual myometrial thickness was 3.0 mm (range 2.0-10.0). Eight women (66.7%) received primary medical management with systemic methotrexate and four (33.3%) underwent surgical or combined treatment. Surgical procedures included laparoscopy (n=3), laparotomy (n=1), suction evacuation (n=2), uterine artery embolisation (n=1), Foley balloon tamponade (n=1), scar repair (n-1), and hysterectomy (n=1). One woman required blood transfusion; no intensive care admission or postoperative complication was documented. Median hospital stay was 11 days (range 2-20). Conclusion: Early transvaginal ultrasound enabled diagnosis before haemodynamic compromise in this series. Management was individualised according to viability, beta-hCG, myometrial thickness, and operative findings. Standardised ultrasound reporting and documentation of serial beta-hCG resolution, reintervention, and reproductive outcomes are essential for comparing treatment strategies.
Keywords: ceasarean scar pregnancy, ectopic pregnancy, methotrexate, transvaginal ultrasonography, previous ceasarean
How to Cite?: Dr. Zico Dasilva, Dr. Gayle Fernandes, Dr. Akankshya Nayak, Dr. Gaurish Sankhalkar, "Clinical Presentation, Ultrasound Characteristics, and Management Outcomes of Caesarean Scar Pregnancy: A 12-Case Series", Volume 15 Issue 7, July 2026, International Journal of Science and Research (IJSR), Pages: 2267-2270, https://www.ijsr.net/getabstract.php?paperid=MR26726145525, DOI: https://dx.doi.org/10.21275/MR26726145525