Ruptured Caesarean Section Scar Ectopic Pregnancy: A Rare Case Report And First to be Reported at Alex Ekwueme Federal University Teaching Hospital Abakaliki.

Abstract

Caesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy, characterized by blastocyst implantation in a previous caesarean scar. The incidence is approximately 1:2000 pregnancies and with increasing incidence of caesarean section worldwide, more and more cases are diagnosed and reported. Very few cases have been documented in Africa, and this is the first case to be reported in Nigeria. Misdiagnosis or a delay in diagnosis or treatment can lead to life-threatening complications such as uterine rupture, haemorrhage and significant maternal morbidity and mortality. Diagnosis of CSP remains a challenge in sub-sahara Africa where early ultrasound are rarely done among majority of pregnant women who are either unbooked or registered for antenatal care in a maternity home supervised by unskilled birth attendant. Even where first trimester ultrasound is done, the availability of high resolution ultrasound and the skill for such sonography may be lacking. We present a case of 38 year old G3P2⁺⁰A2 with history of two previous caesarean section scars who had emergency exploratory laparotomy and uterine repair on account of slow leaking ectopic pregnancy from  ruptured CSP and highlight the complications associated with late diagnosis of such case.  

Keywords: Cesarean scar pregnancy, ectopic pregnancy, uterine rupture, uterine repair