Surgical management of cesarean scar ectopic pregnancy: hysterotomy by transvaginal approach

Objective: To report on the surgical management of a cesarean scar ectopic pregnancy (CSEP) by transvaginal hysterotomy. Design: Case report. Setting: University hospital. Patient(s): A 29-year-old woman, with previous cesarean delivery, presenting with vaginal bleeding, was transfered to our hospital at 5 weeks 4 days of gestation. Transvaginal ultrasonography confirmed the diagnosis of CSEP. Intervention(s): Hysterotomy by transvaginal approach of the CSEP. Main Outcome Measure(s): During the operation, there were no significant complications. Postoperative ultrasonography showed complete disappearance of the ectopic gestational sac. Result(s): Good recovery of the patient and return of normal menstruation. Conclusion(s): Surgical removal of the ectopic mass by transvaginal hysterotomy may be a less invasive approach in cases of CSEP. This case report offers an alternative treatment to other proposed methods for CSEP, with a short operative time and minimum blood loss. (Fertil Steril (R) 2011; 96: e25-8. (C) 2011 by American Society for Reproductive Medicine.)