Objective: To report the diagnosis and management of an ectopic pregnancy (EP) developing in a caesarean section scar.
Design: Case report.
Setting: University medical school.
Patient(s): A patient with a previous history of two caesarean sections developing an EP.
Intervention(s): Methotrexate (MTX) was administered locally under ultrasonographic guidance.
Main outcome measure(s): Weekly screening of blood hCG levels and yolk sac resorption by endovaginal sonography.
Result(s): The diagnosis was suspected by vaginal echography and confirmed by magnetic resonance imaging. Local injection of KCl and MTX provoked a progressive resorption of the pregnancy. Human chorionic gonadotropin was undetectable on day 82.
Conclusion(s): To prevent uterine rupture in cases of an EP developing in a caesarean section scar, a medical approach can be proposed.