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

## TL;DR

A rare case of ectopic pregnancy in a cesarean scar was successfully treated with methotrexate injection and balloon catheter compression.

## Contribution

This case report highlights a novel combination of medical and mechanical interventions for early-stage cesarean scar ectopic pregnancy.

## Key findings

- Ultrasound-guided methotrexate injection and balloon catheter compression led to a rapid decline in β-hCG levels.
- The treatment resulted in resolution of the ectopic pregnancy without surgical intervention.
- Early diagnosis and coordinated multidisciplinary care were critical to successful management.

## 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.