* Department of Gynecology, Félix Guyon’Hospital, 97400 Saint-Denis, Ile de la Réunion, France.
** Inner Vision Women's Ultrasound, Nashville, Tennessee, USA.

Case report

Case 1

A 30-year-old woman (G3P2) was sent to our unit due to vaginal bleeding during first trimester of pregnancy. Her previous deliveries were cesarean sections. Abdominal and transvaginal scans revealed empty uterine cavity with intramural isthmic location of the gestational sac within the uterine scar of previous cesarean section.

The patient underwent Methotrexate therapy after which her levels of hCG had decreased gradually during three weeks. The patient had become pregnant six month later with normal intrauterine location of the pregnancy.

Images 1A, 1B: Images show location of the gestational sac within the uterine scar of the previous cesarean scar.

Case 2

Similar case of a 30-year-old woman with two previous cesarean sections. Abnormal bleeding was also present and the ectopic pregnancy was within the uterine scar. She also underwent successful Methotrexate therapy.

Images 2A, 2B: Images show location of the gestational sac within the uterine scar after previous cesarean pregnancy.

Case 3

Another case of ectopic cesarean pregnancy presented with abnormal bleeding and treated with Methotrexate therapy.

Images 3A, 3B: Images show location of the gestational sac within the uterine scar.

Case 4

Similar case of ectopic pregnancy within uterine scar presented with abnormal vaginal bleeding and consequent successful Methotrexate therapy.

Images 4A, 4B: Images show location of the gestational sac within the uterine scar.