Non-developing pregnancy in the uterine scar after caesarean section: diagnostic difficulties

Background: The steady increase in the number of patients with a history of even one caesarean section leads to a rise in the frequency of such form of ectopic pregnancy, as pregnancy in the scar. The choice of the optimal organ-sparing treatment option for this category of patients depends on timely diagnosis. The formation of retrochorial hematoma that accompanies non-developing pregnancy in the scar in the early stages significantly complicates the diagnosis.

Case report: The paper describes a clinical case of a reproductive-aged patient, in whom a long episode of menometrorrhagia ended with the formation of a round mass up to 8 cm in diameter in the area of the scar after cesarean section at the uterine isthmus. Erroneously diagnosed incomplete abortion during uterine pregnancy and uterine fibroids served as a reason for uterine curettage complicated by massive blood loss. The final diagnosis was established after pathological mass excision and metroplasty.

Conclusion: A pathological uterine mass localized in the scar area after cesarean section, which is suddenly detected during abnormal uterine bleeding, requires the exclusion of pregnancy in this area. Correct diagnosis of non-developing pregnancy in the scar is the key to successful organ-sparing surgery.