title: Caesarian Scar Pregnancy- a Diagnostic Dilemma.
abstract: Caesarean scar pregnancy is one of the rarest forms of ectopic pregnancy. Transvaginal ultrasound and color flow Doppler provides a high diagnostic accuracy. A delay in diagnosis and treatment can lead to uterine rupture, major hemorrhage, hysterectomy and serious maternal morbidity and mortality. Early diagnosis can offer treatment options of avoiding uterine rupture and hemorrhage, thus preserving the uterus and future fertility. Primary health care provider should know about this rare entity, because if diagnosed timely, and referral to specialized centre is done without delay will definitely save maternal morbidity and mortality. Management plan should be individualized. Termination of pregnancy is the treatment of choice in the first trimester. Expectant treatment has a poor prognosis because of risk of rupture. In this case report we aim to discuss the associated diagnostic dilemma, most appropriate methods of diagnosis and management, with their implications in clinical practice.
authors.affiliation: Department of Gynecology and Obstetrics, Post Graduate Institute of Medical Sciences and Research, ESIC, Basaidarapur, New Delhi,India.
authors.forename: P
authors.initials: P
authors.lastname: Gupta
authors.affiliation: Department of Gynecology and Obstetrics, Government Medical College & Hospital, Chandigarh, India.
authors.forename: A
authors.initials: A
authors.lastname: Huria
authors.affiliation: Department of Gynecology and Obstetrics, Government Medical College & Hospital, Chandigarh, India.
authors.forename: D
authors.initials: D
authors.lastname: Kaur
authors.affiliation: Department of Gynecology and Obstetrics, Post Graduate Institute of Medical Sciences and Research, ESIC, Basaidarapur, New Delhi,India.
authors.forename: R
authors.initials: R
authors.lastname: Mehra
mesh_terms: D000032:Abortion, Therapeutic; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000150:complications*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007044:Hysterectomy; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D014592:Uterine Hemorrhage / Q000517:prevention & control; D014597:Uterine Rupture / Q000517:prevention & control
keywords: scar pregnancy; caesarian section; methotrexate.