Publication:

A case of caesarean scar ectopic pregnancy presented as post medical termination of pregnancy with cervical hematoma

A 36 years old woman (P2L2MTP2 with previous 2 LSCS) came with complaints of pain in abdomen and bleeding per vaginum with severe anaemia. Patient had a history of surgical MTP done 3 weeks back. USG was suggestive of hematoma at the isthmico-cervical junction. A provisional diagnosis of post-surgical MTP ruptured/perforated uterus with hypovolemic shock was made. A laparotomy was carried out. Intraoperatively, the isthmico-cervical junction was ballooned up and after incision over the isthmic scar of previous LSCS a large blood clot was retrieved. Histopathology of the scar tissue confirmed the diagnosis of scar ectopic pregnancy. In all cases of previous caesarean scar uterus, ultrasonography must be performed before first trimester surgical MTP to rule out the caesarean scar ectopic pregnancy. If USG is not performed preoperatively and with persistent postoperative vaginal bleeding, then always rule out the partial disruption of unknown caesarean scar ectopic pregnancy by USG and serum Beta hCG levels.