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Difficulty in Diagnosing Cesarean Scar Pregnancy Using Magnetic Resonance Imaging: Importance of Color Doppler Assessment in Treatment Decision-Making

Year: 2026

Type: article

Abstract: Cesarean scar pregnancy (CSP) is a rare but potentially life-threatening form of ectopic pregnancy, and its diagnosis may be challenging in early pregnancy. We report a case of a 40-year-old woman with a history of one cesarean section who was referred with suspected cervical pregnancy. Transvaginal ultrasonography demonstrated a cystic lesion at the cesarean scar site without detectable blood flow, whereas magnetic resonance imaging (MRI) suggested right adnexal ectopic pregnancy. Laparoscopic surgery was initiated; however, no adnexal pregnancy was identified, and the procedure was converted to ultrasound-guided uterine evacuation without preoperative uterine artery embolization. Chorionic villi were confirmed pathologically, and the postoperative course was uneventful. This case highlights that MRI findings may be atypical in early CSP and that color Doppler ultrasonography of peritrophoblastic blood flow may be useful for treatment planning, including decisions on preoperative uterine artery embolization.

Source: Cureus

DOI: 10.7759/cureus.117077

Authors: Kaoru Yamada, Keita Hasegawa, Kaori Suenaga, Yoshiyuki Mochimaru, Toru Arase

Institution: keiyu Hospital

Language: English

Topic: Ectopic Pregnancy Diagnosis and Management

Subfield: Obstetrics and Gynecology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7214576333