Point-of-care ultrasound (POCUS) for diagnosing cesarean scar ectopic pregnancy in the emergency department

Background

Cesarean scar ectopic pregnancy (CSEP) is a rare but potentially life-threatening type of ectopic pregnancy in which implantation occurs within the myometrial defect of a prior cesarean scar. Early recognition is critical due to the risk of severe hemorrhage, uterine rupture, loss of fertility, and maternal death. We report a case of CSEP diagnosed by point-of-care ultrasound (POCUS), highlighting key sonographic findings. Case Presentation: A 37-year-old female presented with lower abdominal pain and amenorrhea. Investigations were positive for pregnancy. POCUS revealed a viable ectopic pregnancy embedded within the myometrium at the cesarean scar, with endogenous growth toward the uterine cavity. These findings were consistent with CSEP, which prompted an emergent obstetric consultation for definitive treatment.