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Cesarean scar pregnancy: “A rarity no more?” A report of 2 cases

Denise Elaine A. Reyes, MD; Lylah D. Reyes, MD, MSc, FPOGS; Michelle E. Gamboa, MD, FPOGS; Romerico F. Torres, MD, FPOGS
Department of Obstetrics and Gynecology, Far Eastern University - Nicanor Reyes Medical Foundation Medical Center

Cesarean scar pregnancy is the rarest form of ectopic pregnancy. In the Philippines, little is known about its incidence and occurrence. However, increasing rates has been documented worldwide, closely related to the increasing cesarean section rates. This paper reports two cases of cesarean scar pregnancy who both presented with vaginal bleeding. The first case, a Gravida 6 Para 5 (5005), while the second case, a Gravida 3 Para 2 (2002). Both diagnosed early by ultrasonography but managed differently. The first case, managed by hysterectomy, while the second case, managed conservatively by laparoscopic excision of the cesarean scar pregnancy. This paper intends to raise awareness of the increasing incidence of cesarean scar pregnancy, its pathophysiology, different options in the diagnosis and management.

Prevention is the key to decrease the incidence of cesarean scar pregnancy. To achieve this, reducing the cesarean section rate should be the primary goal.