Laparoscopic repair combined with hysteroscopy of cesarean section scar after cesarean scar pregnancy resulting in a live birth: A case report.

This case report describes a 31-year-old woman with cesarean scar syndrome (CSDi) secondary to cesarean scar pregnancy (CSP) who had persistent abnormal imaging and chronic pelvic pain with secondary infertility after methotrexate failed to resolve the gestational sac and dilation and curettage was performed hysteroscopically. Using laparoscopic repair combined with hysteroscopy (including suprapubic access to excise and wedge-debride the uterine thinning into a two-layer myometrial closure), the authors report increased residual myometrial thickness from 6 mm preoperatively to 13 mm at 6 months, followed by spontaneous conception at 8 months without re-thinning during the pregnancy and a successful elective cesarean delivery at term. The paper’s major limitation is that it is a single patient experience with no established evidence that scar repair prevents recurrent CSP. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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