ArticleCase reports in women's health2026
Fertility-preserving management of heterotopic cesarean scar pregnancy after laparoscopic repair for cesarean scar disorder: a case report.
Article in Case reports in women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Heterotopic pregnancy involving cesarean scar implantation is rare and difficult to manage when continuation of a viable intrauterine pregnancy is desired. Evidence is particularly limited for cases occurring after surgical repair for cesarean scar disorder. A 40-year-old woman with three previous cesarean deliveries underwent laparoscopic repair for symptomatic cesarean scar disorder before assisted reproductive technology. After transfer of two blastocysts, transvaginal ultrasonography showed a viable intrauterine pregnancy together with a cesarean scar pregnancy of the in-the-niche type with minimal overlying residual myometrium. Because the patient wished to continue the intrauterine pregnancy, selective treatment of the scar gestation was performed. Ultrasound-guided local potassium chloride injection led to gradual regression of the cesarean scar pregnancy without significant bleeding or procedure-related complications. The intrauterine pregnancy continued under close surveillance, and an elective repeat cesarean delivery at 37 weeks resulted in the birth of a healthy neonate. Histopathology of residual tissue at the repaired scar was compatible with a placental remnant. Selective local potassium chloride injection may be considered a fertility-preserving option for heterotopic cesarean scar pregnancy after surgical repair for cesarean scar disorder in carefully selected patients. Early diagnosis, careful counseling, and management in a tertiary care setting are essential.
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