Successful live birth following robotic-assisted management of a cesarean scar pregnancy: a promising pathway

Cesarean scar pregnancy (CSP) is a variant of uterine ectopic pregnancy defined by full or partial implantation of the gestational sac in the scar of a previous cesarean section. The most usual recommendation is termination of pregnancy in the first trimester. In this article, we present a case of live birth after detecting CSP in early pregnancy and robotic scar reinforcement surgery, effectively relocating the pregnancy into the cavum. At 25+3 gestational weeks, an emergency caesarean section was performed. A girl weighing 800 g was delivered with APGAR 7/7/9. The percrete area of the placenta was excised and the uterus could be preserved. Prolongation of CSP and consecutive live birth is feasible and can be achieved. Using robotic surgical approach for both the scar reinforcement surgery as well as the surveillance of the pregnancy including caesarean section with management of placenta percreta require high expertise and specialized centres.