Clinical Characteristics and Management Outcomes of Cesarean Scar Ectopic Pregnancy: A Retrospective Cohort Study

Background: Cesarean scar ectopic pregnancy (CSEP) is a rare but potentially life-threatening form of ectopic pregnancy, with increasing incidence parallel to rising cesarean delivery rates. The aim of this study was to describe the clinical characteristics and evaluate management outcomes of cesarean scar ectopic pregnancy cases. Methods: This retrospective observational descriptive study was conducted at the Obstetrics and Gynecology Department, Zagazig University Hospitals. A total of 104 women diagnosed with CSEP were included and stratified according to the initial management strategy into expectant, medical (methotrexate), and surgical groups. Data on clinical presentation, laboratory findings, ultrasonographic features, treatment modalities, complications, and outcomes were extracted from medical records. Treatment success was defined according to the initial management strategy. Results: Serum β-hCG levels at presentation were higher among patients requiring laparotomy (p < 0.001), and hemodynamic instability and symptomatic presentation were more common in this group. Type II CSEP was more frequently associated with laparotomy (p