Successful Management of Cesarean Scar Pregnancy in a Tertiary Care Hospital in North India: A Case Series.

Aim and background: The incidence of cesarean scar pregnancy (CSP) varies from 1/1,800 to 1/2,500 of all pregnancies, which comprises almost six percent of all ectopic pregnancies, in patients with at least one previous cesarean section, and it has increased due to a rise in the number of cesarean deliveries and early detection due to better imaging modalities. Case description: In this case series, three women with early pregnancy presented to the emergency room at our hospital with complaints of lower abdominal pain and spotting or bleeding per vaginum. Diagnosis of CSP was made after performing a transvaginal ultrasound (TVUS) and CSP was successfully managed using systemic methotrexate (MTX) and uterine artery embolization (UAE) in one case and instillation of intracardiac potassium chloride (KCl) along with injecting MTX in the gestational sac in two cases. Beta human Chorionic Gonadotrophin (β-hCG) was measured every week for follow-up until negative. Conclusion: Cesarean scar pregnancy was managed using different modalities depending on the presenting complaints of the woman, clinical features, imaging, and the presence of cardiac activity. Clinical significance: Early detection and timely interventions in CSP are associated with reduced maternal morbidity and mortality. [ABSTRACT FROM AUTHOR]