Caesarean scar ectopic a new phenomenon or a consequence of the rise in Caesarean section rates.

Laparoscopic view of Caesarean scar ectopic preganancy

There are an increasing number of women delivering their babies by Caesarean section. In some centres the rate can be in excess of 30%.

Though some women need to have Caesareans for medical reasons, there is also a rise in the number of women requesting Caesarean sections for a number of reasons.


Whatever the reason for Caesarean section, apart from increasing the risk of repeat Caesarean section for subsequent births, there are also long term consequences of caesarean section.

These include:

• Chronic pelvic pain
  
• Endometriosis
  

                 Increased risk of the cells that line the lining of the womb spilling out and growing outside the uterus

• Caesarean scar ectopic
  
• Post menopausal bleeding
  

                Caesareans have been implicated in causing scar tissue and pouches that can later bleed after the      menopause

• Increased Hysterectomy rates
  

               The increase here is from increased incidence of adhesions pelvic pain, and abnormal menstrual bleeding
Increased in the risk of Menorrhagia (heavy abnormal menstrual bleeding

• Increased risk of Adhesions (scar tissue)
  
• Intrauterine adhesions (Scarring of the inside of the womb) also known as Asherman's syndrom
  

This can lead to problems with future fertility


Caesarean scar ectopic pregnancy is where the pregnancy implants in the deficiency that is caused by the scar from Caesarean section.

It presents with pain and bleeding after missing a period and having a positive pregnancy test.

The diagnosis is often confused with a miscarriage, as the pregnancy lies low in the uterine cavity. The two conditions are differentiated by particular finding on ultrasound scan.

Once the diagnosis is made treatment can either be by medical management with methotrexate or by means of surgery. Increasingly the surgery is carried out by the keyhole approach

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