Myomectomy scar ectopic pregnancy

A majority of ectopic pregnancies occur in the fallopian tube. Hysterotomy scar pregnancies are unusual; most often, they are discussed in relation to caesarean scar sites, with an incidence of about 1 in 2000 pregnancies. Our case concerns a particular variant – the myomectomy scar pregnancy, where a pregnancy within the scar is surrounded by myometrium and connective tissue. This is an especially uncommon type of intramural ectopic pregnancy, which in itself is rare, a recent literature review citing 34 previous cases globally. A postulated mechanism for implantation in uterine scars is embryonic migration through microscopic fistulae within the scar.