An ectopic pregnancy developing in a previous caesarian section scar.

OBJECTIVE: To report the diagnosis and management of an ectopic pregnancy (EP) developing in a caesarean section scar. DESIGN: Case report. SETTING: University medical school. PATIENT(S): A patient with a previous history of two caesarean sections developing an EP. INTERVENTION(S): Methotrexate (MTX) was administered locally under ultrasonographic guidance. MAIN OUTCOME MEASURE(S): Weekly screening of blood hCG levels and yolk sac resorption by endovaginal sonography. RESULT(S): The diagnosis was suspected by vaginal echography and confirmed by magnetic resonance imaging. Local injection of KCl and MTX provoked a progressive resorption of the pregnancy. Human chorionic gonadotropin was undetectable on day 82. CONCLUSION(S): To prevent uterine rupture in cases of an EP developing in a caesarean section scar, a medical approach can be proposed.