Cesarian Scar Ectopic Pregnancy: A Tertiary Maternity Hospital Case Series

Background and objective: Higher rates of cesarean section nowadays were accompanied with increased incidence of cesarean scar ectopic pregnancy. The purpose of this study was to investigate the clinical characteristics, therapy and outcome of the caesarean scar ectopic pregnancies Methods: A cross-sectional study implemented in the Maternity Teaching Hospital in Erbil city-Kurdistan region/Iraq through the period of one year from 1st of May 2022, to 30th of April 2023 on sample of 25 women with cesarean scar ectopic pregnancy. The cesarean section ectopic pregnancy was diagnosed in hospital according to history, clinical examination and ultrasonography findings. This study examined characteristics, history, diagnostics, management, and outcomes of pregnant women with cesarean scar ectopic pregnancy Results: Mean age of the women was 31 years and 52% of them were obese. The presenting symptom of cesarean-section ectopic pregnancy among studied women was vaginal bleeding (52%), followed by missed periods (24%), pain & bleeding (16%) and only pain (8%). Common initial management of women with CSEP was medical treatment (76%), followed by combined treatment (16%) and surgical treatment (8%). The mean gestational age was significantly longer among women with cesarean scar ectopic pregnancy treated surgically, while shorter in women treated medically (p=0.001). Conclusions: The risk factors of cesarean-section ectopic pregnancy are increased age, obesity, grand multi-gravidity, prior cesarean-sections and common presentation is vaginal bleeding at early gestational age.