Case challenge · Imaging / Obstetrics / Ultrasound · teaching

Cesarean Scar Pregnancy (CSP) Ultrasound Diagnosis · case challenge

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← View the full flowchartBased on SMFM #63 / Vial

Case #1Imaging / Obstetrics / Ultrasound

📋 Case data

Gestational sac location and typeType 1 endophytic (growing toward cavity/isthmus, reasonable residual myometrium)

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Step 1 / 1 · Gestational sac location and type

Gestational sac location and residual myometrium — scar pregnancy? Type?

💡 CSP = gestational sac implanted in a prior cesarean scar/niche, can cause hemorrhage/uterine rupture/placenta accreta (PAS). TVUS preferred (semi-filled bladder). Criteria: 1) empty uterine cavity and cervical canal; 2) sac/placenta embedded in the scar (anterior lower segment isthmus at the internal os level); 3) sac filling the scar niche; 4) thin myometrium between sac and bladder (1–3 mm) or absent; 5) rich trophoblastic Doppler flow (high velocity, low resistance).

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.