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Successful Management of Cesarean Scar Ectopic Pregnancy Using Local Methotrexate Injection and Balloon Catheter Compression: A Case Report

Year: 2025

Type: article

Abstract: Cesarean scar ectopic pregnancy (CSEP) is a form of non-tubal ectopic pregnancy. The diagnosis is made based on a combination of elevated beta human chorionic gonadotropin (β-hCG) levels and transvaginal ultrasound findings. In this case, a 32-year-old woman at 6.5 weeks gestation presented with abdominal cramping and vaginal bleeding. Transvaginal ultrasound confirmed a gestational sac implanted in the cesarean scar. After multidisciplinary consultation between obstetrics/gynecology and interventional radiology, the patient underwent ultrasound-guided intra-gestational methotrexate injection followed by balloon catheter compression. The results of the procedure included a rapid decline in β-hCG levels and resolution of the ectopic pregnancy. This case demonstrates the effectiveness of combining medical and mechanical interventions in early-stage CSEP and reinforces the importance of early diagnosis and coordinated care. Further research is needed to develop standardized treatment protocols for this rare condition.

Source: Cureus

DOI: 10.7759/cureus.92400

Authors: Natalie M George, Madhav Barot, Reham Haroun

Institutions: Michigan State University, Henry Ford Health

Language: English

Topic: Ectopic Pregnancy Diagnosis and Management

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4414192099