Conservative treatment by endoscopy of a cesarean scar pregnancy: two case reports.

Background: Cesarean section scar pregnancy is the rarest form of ectopic pregnancy and the most dangerous due to the high risk of uterine rupture and hemorrhage.

Methods: We present two case reports of women diagnosed with an ectopic cesarean scar pregnancy. We performed conservative treatment because both patients desired fertility preservation. The first case was treated with laparoscopy and hysteroscopy simultaneously. For the second case the treatment started with an ultrasound-guided injection of methotrexate. Surgical laparoscopy and hysteroscopy were subsequently performed simultaneously. Four months later, the first woman had a spontaneous singleton pregnancy. An elective cesarean was performed.

Conclusions: In these two case reports we have presented our experience with endoscopic surgery in the management of two patients who had a cesarean scar pregnancy and desired to preserve their fertility.