Successful term pregnancy after treatment of a cesarean scar ectopic gestation by endoscopic technique and conservative therapy.

OBJECTIVE: To describe a case of cesarean scar pregnancy treated successfully by endoscopic technique and medical therapy. DESIGN: Case report. SETTING: State general hospital in a major city. PATIENT(S): A 32-year-old woman with two cesarean sections and a recent curettage presented with ectopic cesarean scar pregnancy. INTERVENTION(S): Transvaginal ultrasound and hysteroscopy were used for diagnosis, and conservative therapy with methotrexate and hysteroscopy to treat the patient. MAIN OUTCOME MEASURE(S): Modified hysteroscopic technique and outcome. RESULT(S): Sonography and hysteroscopy revealed the presence of a gestational sac in the lower segment of the uterus in a patient with a cesarean section scar. She was successfully treated with systemic methotrexate and aspiration of the sac and local methotrexate injection under endoscopic control. CONCLUSION(S): Endoscopic intervention combined with medical treatment can result in a good therapeutic outcome with preservation of fertility in early ectopic cesarean scar pregnancy.