Cesarean section scar ectopic pregnancy: a clinical case series.

Cesarean scar implantation represents a rare, though growing subset of potentially life-threatening ectopic pregnancy. Because of the global increase in cesarean sections as well as the improved diagnostic abilities of transvaginal ultrasound, incidence rates have continued to rise since the first reported case in 1978. Uterine rupture and catastrophic hemorrhage can ensue when diagnosis is delayed. Additionally, a higher rate of concurrent trophoblastic myometrial invasion may increase the incidence of retained products of conception or post procedural bleeding. Endovaginal ultrasound has a reported sensitivity of 85 % for detection. In difficult cases, magnetic resonance imaging is often useful as a problem solving exam in confirming diagnostic suspicions and guiding therapeutic decisions. We present a series of five illustrative cases illustrating the range of clinical and imaging findings.