Introduction: With the increasing caesarean delivery rates, the risk of caesarean scar pregnancy is increasing. However, owing to its rarity, it poses as a diagnostic and therapeutic dilemma for the obstetrician.
Case report: A 33 year old lady G3P1L1A1 at 8 weeks 3 days period of gestation was diagnosed as a case of viable caesarean scar pregnancy. She was treated with intracardiac potassium chloride, and intragestational sac and placental Methotrexate injection. She was followed up and at 12 weeks post treatment serum β HCG normalized and endometrial cavity was empty on transvaginal sonography.
Conclusion: Diagnosis of caesarean scar pregnancy is difficult, but transvaginal sonography and colour flow Doppler may be helpful. Though the best and standard management is still unclear for this condition, the use of intracardiac KCl, and intra sac and placental Methotrexate can be considered in cases of viable caesarean scar pregnancy.