Cesarean Scar Ectopic Pregnancy

This podcast provides clinical guidance regarding cesarean scar ectopic pregnancy (CSEP), a dangerous condition where an embryo implants in the scar of a previous cesarean delivery. Because CSEP carries high risks for maternal morbidity and mortality, the authors emphasize the necessity of early diagnosis primarily through transvaginal ultrasound. The guidelines strongly recommend against expectant management due to the likelihood of severe complications like uterine rupture or massive hemorrhage. Instead, they suggest surgical resection or ultrasound-guided aspiration, while cautioning that systemic methotrexate should not be used as a standalone treatment. The text concludes by advising patients on the high risk of recurrence in future pregnancies and the importance of effective contraception for those who have experienced this condition.