Journal des méthodes de diagnostic médical
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A Report of Four Cases of Caesarean Scar Pregnancy in a Period of 24 Months

Wael El Guindi, Mahmoud Alalfy, Amr Abasy, Ahmed Ellithy, Ahmed Nabil1 , Omar Abdalfatah, Mohamed Ramadan and Sondos Salem

Abstract
The implantation of a pregnancy within the scar of a previous caesarean delivery is the rarest of ectopic pregnancy locations. If it is diagnosed early, treatment options are capable of preserving the uterus and subsequent fertility.
Objective: Pregnancy in previous caesarean scar is the rarest form of ectopic pregnancy. We aimed to present 4 cases of caesarean scar ectopic pregnancy and assess the potential role of three dimensional ultrasonography in the diagnosis.
Design: We report 4 cases of caesarean scar pregnancies; one of them was initially mistaken for a viable intrauterine pregnancy.
Results: 2 cases had transcervical aspiration of the gestational sac and two by open surgery. One underwent hysterectomy and the other laparotomy and excision of the pregnancy located in the CS scar.
Conclusions: We report on four cases of caesarean scar pregnancy with different modes of treatment. The three dimensional ultrasound improved visualisation of the caesarean scar pregnancy. Care should be taken in the diagnosis of caesarean scar twin pregnancy by a transvaginal ultrasonography in order to not mistake a caesarean scar pregnancy for an intrauterine pregnancy.