Ectopic pregnancy is characterized by the implantation of the blastocyst in a cavity
other than the endometrial surface of the uterus. The most common location for this
type of pregnancy is in the uterine tube, specifically in the ampullary region. An ectopic
pregnancy in the uterine scar of a cesarean section is considered the rarest
presentation of ectopic pregnancy and of high morbidity and mortality. Its
pathophysiology is still poorly elucidated, but it is understood to be a pregnancy
inserted into the uterine cesarean scar, surrounded by myometrium and fibrous tissue.
In recent years, the substantial increase in cesarean sections performed has been one
of the primary factors in the appearance of this pregnancy. The clinical picture,
hormonal dosages, and imaging studies are used for the diagnosis, which will be
relevant in defining the most appropriate therapy for each case, from conservative
treatment to surgery. Objective: to report a rare case of ectopic pregnancy in a
cesarean section uterine scar that occurred in a reference hospital for high-risk
pregnant women in the state of Pará. Methodology: secondary, observational,
descriptive and retrospective study, by reviewing medical records. Case report: a 24-
year-old, female patient, G3P2CA0, was admitted to a highrisk maternity ward in
Belém/PA, with pelvic pain and vaginal bleeding in moderate quantity, presenting pain
on superficial palpation in the left iliac region. The beta-HCG and imaging exams, such
as transvaginal ultrasound, indicated ectopic pregnancy and, by means of exploratory
laparotomy, an embryo and ovarian remains were identified in the region of the
previous cesarean incision. Conclusion: Thus, we conclude that ectopic pregnancy in
a cesarean section scar is an exceptional case of a non-tubal ectopic pregnancy with
high mortality. Fortunately, there was a favorable outcome to the patient's condition.
However, more studies are needed that delve into the subject that can help deal with
the challenge for the medical team that is the decision about the best therapeutic
conduct at each stage of pregnancy.
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