Cesarean scar ectopic pregnancy- MRI

Discussion –— Cesarean scar ectopic pregnancy (CSEP) or Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy resulting from implantation of a blastocyst within myometrial scar tissue (old uterine scars) in the anterior lower uterine segment (LUS) at the site of prior Cesarean section.— It is considered amongst the rarest type of ectopic pregnancy, although some do not include it in the category of ectopic pregnancy as implantation occurs within the uterus itself.— Incidence is on rise due to increasing numbers of elective Cesarean sections as well as improved detection with transvaginal ultrasound (TVUS). — Estimated incidence is  about 1 per 1,800-2,226 pregnancies, exceeding than that of cervical ectopic pregnancies.Clinical presentation -— Vaginal bleeding and abdominal pain.—  Severe acute abdominal pain or heavy vaginal bleeding are concerning for impending rupture.— Hemodynamic instability may indicate rupture of CSP through the myometrium.— Up to 40 percent of patients may remain asymptomatic.— CSP can present at any time during gestation.PATHOLOGY- — Myometrial defects result from prior Cesarean section or after other uterine interventions like, dilatation and curettage ( D& C), myomectomy, hysteroscopy, and metroplasty.— Poor vascularity in the LUS impairs healing of scar and contributes to the formation of small myometrial defects in which the trophobla...
Source: Sumer's Radiology Site - Category: Radiology Authors: Source Type: blogs