Cesarean scar ectopic pregnancy is a rare type of abnormal implantation. It is often considered the rarest type of ectopic pregnancy, although some do not include it in this category as implantation occurs within the uterus.

This patient had three prior live pregnancies delivered by cesarean. On this occasion the gestational sac implanted at the cesarean scar and trophoblastic tissue grew through the thickness of the myometrium, as seen on the ultrasound. Notice the unusual morphology of the low-lying gestational sac, which has a tear-drop appearance on longitudinal view.

The pregnancy was terminated due to the risk of uterine rupture if the pregnancy were to progress any further.