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

Document Type

Article

Publication Date

9-1-2025

Publication Title

Cureus

Keywords

cesarean scar pregnancy; ectopic pregnancy; interventional radiology; methotrexate; obstetrics & gynecology (ob-gyn) services

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.

PubMed ID

41111657

Volume

17

Issue

9

First Page

92400

Last Page

92400

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