Importance of Early Detection of Cesarean Scar Ectopic Pregnancy

Although still rare, the incidence of cesarean scar ectopic pregnancies has increased in the past few years due to the number of cesarean section deliveries being performed. If left untreated, this can have devastating complications for patients, including hemorrhage, uterine rupture, and maternal death. Occurrence of cesarean scar ectopic is about 1 in 2000 pregnancies. Most of these pregnancies have a normal rising beta-human chorionic gonadotropin (beta-hCG), and patients may present asymptomatic, with light spotting during early first trimester and with or without cramping. Due to rarity, there is very minimal awareness among sonographers of the likelihood of cesarean scar ectopic, which can be misdiagnosed as cervical pregnancy or spontaneous abortion in progress. Ultrasound is the primary imaging modality and plays a very important role in recognizing and providing proper early diagnosis.