• Ioannis Korkontzelos, Panagiotis Tsirkas, Nikolaos Antoniou, Dimitrios Souliotis, and Ioannis Kosmas.
• Department of Obstetrics and Gynecology, Ioannina State General Hospital G Chatzikosta, Ioannina, Greece. i.korkontzelos@yahoo.com
• Fertil. Steril. 2008 Nov 1; 90 (5): 2010.e13-5.

ObjectiveTo describe a case of cesarean scar pregnancy treated successfully by endoscopic technique and medical therapy.DesignCase report.SettingState general hospital in a major city.Patient(S)A 32-year-old woman with two cesarean sections and a recent curettage presented with ectopic cesarean scar pregnancy.Intervention(S)Transvaginal ultrasound and hysteroscopy were used for diagnosis, and conservative therapy with methotrexate and hysteroscopy to treat the patient.Main Outcome Measure(S)Modified hysteroscopic technique and outcome.Result(S)Sonography and hysteroscopy revealed the presence of a gestational sac in the lower segment of the uterus in a patient with a cesarean section scar. She was successfully treated with systemic methotrexate and aspiration of the sac and local methotrexate injection under endoscopic control.Conclusion(S)Endoscopic intervention combined with medical treatment can result in a good therapeutic outcome with preservation of fertility in early ectopic cesarean scar pregnancy.

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