“Pregnancy in a Cesarean Section” scar. Eleven years after a Cesarean Section the patient got pregnant in the scar. Specific attention is to go to the distance between the insertion and the serosa. When the measured distance is less than 1.5 mm medical treatment is in order.

Here the distance measured was 3.5 mm and this distance is considered to allow for very gentle suction curettage. If the measurements indicate over 4 mm a suction curettage is the norm. We did opt for a suction curettage under ultrasound control. The bladder is filled with physiological solution and an abdominal scan is performed (Kostas Panayotidis – Bruno van Herendael FIGO 2012).

The curette is brought in under US guidance and the pregnancy is aspirated under US view. To be sure that the totality of the placentation had been aspirated a hysteroscopy was performed. The hysteroscopy did confirm complete removal. The procedure was performed under general anaesthesia.