MRI in Cesarean Scar Ectopic Pregnancy

Ectopic pregnancy overall is the leading cause of death in the first trimester [1]. The incidence of pregnancy implantation in unusual sites, like cesarean scar is rising due to increased incidence of cesarean sections, pelvic inflammatory disease and dilatation and curettage [2]. Up to 72% of cesarean scar pregnancies occur in women who have had 2 or more cesarean deliveries [3-5]. The dehiscent myometrial defect may be related to incomplete healing or increased fibrosis along the uterine scar. Fibrosis occurring after multiple cesarean deliveries leads to poor vascularity, which impairs healing. Multiple cesarean deliveries also increase the risk of implantation on the scar, likely due to an increased scar surface area [4-6]. Cesarean scar ectopic pregnancy can be devastating because of complications such as uterine rupture and massive hemorrhage, leading to increased maternal morbidity and mortality [7].