Abstract: Background: Scar ectopic is a recent rapidly increasing phenomenon complicating pregnancy occurring in previously scarred uteri.
Objective: To study and evaluate the management of this rare abnormal pregnancy.
Setting: A retrospective observational cohort study, conducted in the Department of Obstetrics and Gynecology, Security Forces Hospital, Riyadh, Saudi Arabia, in the period from June 1st 2017 to July 30th 2019.
Results: A total of 7 cases were studied where the patient characteristics revealed an average age of 35 years, Body Mass Index of 36 Kg/ m2. The Gestational age ranged from 5+5 to 12+6 weeks. In five patients (71.4%) the gestational sac was seen with fetal poles in the ultrasound done for all and MRI for one case, for clarification of diagnosis. Two cases had positive fetal heart (28.6%). The number of previous c/s done for the patients ranged from 1-4 previous cesarean scars. Almost all patients responded to one dose of intramuscular Methotrexate, except for two cases that needed extra doses, one given intramuscular and the other inside the gestational sac. Medical disorders encountered were in the form of bronchial asthma and hyper -prolactinemia in one case and hypothyroidism in another one. The average time needed for Bhcg to return to normal value was 61 days.
Conclusion: Although the number studied was small in a new emerging pathology, yet, the good outcome clearly showed that high vigilance and rapid directed management and follow-up entailing combined treatment was mandatory. So far, the diversity and the instigation of a combination of methods of treatment should be existent until final standard protocols are set.
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