Caesarean Scar Pregnancy: A Retrospective Study of Cases in the years 2000-2023

Objectives: To describe the epidemiological characteristics of Caesarean scar ectopic pregnancy cases attending King Salman bin Abdulaziz Medical City (KSAMC) in the Obstetrics and Gynecology Department, Madinah, Saudi Arabia, and to investigate the impact of different treatment modalities on outcomes and prognosis. Materials and Methods: A cross-sectional study reviewed files of pregnant women who were diagnosed with caesarean scar ectopic pregnancy between January 1, 2000 and December 31, 2023. The retrieved data included diagnosis, case management, and future pregnancies. Results: Medical records of 47 caesarean scar ectopic pregnancy patients were reviewed. All patients have been treated conservatively except one patient who was subjected to surgical treatment that was complicated by severe bleeding and ended with hysterectomy. 51.06% of the patients were managed through ultrasound-guided intrasac methotrexate (MTX) injection. There was no mortality recorded. Conclusions: It is crucial to diagnose and manage caesarean scar ectopic pregnancy patients as early as diagnosed to prevent erroneous morbidities. This research endorses early diagnosis and conservative management with ultrasound-guided injection of the gestational sac.