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Caesarean scar pregnancy (CSP) is a rare entity and can cause serious complications. Early diagnosis is the key to avoid complications. The use of transvaginal ultrasonography (preferably three-dimensional if available) and measurement of serum beta human chorionic gonadotropin (Î²hCG) levels is crucial for early diagnosis and the planning of the management. Here, we present a case of CSP found in 32-year-old women with a history of previous two caesarean sections presented with a history of amenorrhoea and mild pelvic pain. The diagnosis of CSP was made by a transvaginal ultrasound examination and managed successfully. The management involved systemic methotrexate administration. The patient was followed-up by monitoring the serum beta-human chorionic gonadotropin (Î²hCG) level until it reached the non-pregnant level and followed-up with TVS (Transvaginal sonography) scan until complete resolution of the pregnancy sac. Unfortunately, there are no standardized guidelines for the management.
Keywords: Caesarean Scar Pregnancy; Lower uterine segment caesarean section; beta- human chorionic gonadotropin; Methotrexate; Three-dimensional Transvaginal Ultrasonography.