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Aim: To evaluate the efficacy and safety of single dose of of Systemic MTX 50 mg/m2 followed by D&amp;S in cases of Cesarean scar pregnancy (CSP).  Objective: Implantation of the pregnancy in a cesarean scar is a rare condition named; Cesarean scar pregnancy (CSP). Maternal complications can be prevented with the early diagnosis and an appropriate management. It is a prospective clinical study to evaluate the efficacy and success rate of single dose use of methotrexate (MTX) followed by dilation and suction (D&amp;S) regimen in the management of women with cesarean scar pregnancy (CSP).  Methods: 50mg of MTX in the form of a single dose Intramuscular injection then cervical dilatation and suction aspiration with a Karman cannula (D&amp;S) under guidance of ultrasound after 48 preceded by vaginal misoprostol 2 tablet (200 mg) 4 hours ago.  Results: The mean gestational age at diagnosis was (8.5±1.6) and the mean gestational age of pregnancy was 8.5±1.6. The mean level of serum b-human chorionic gonadotrophin was (7424±2.560). 88.7% was the successive rate without complication or need of intervention, 2 (5.7%) patients needed intrauterine foley's catheter for 24 hours as a mechanical hemostasis. 2 (5.7 %) had laparotomy with wedge resection of the gestational sac lesion and successful repair of the uterine defect and one (2.8 %) underwent subtotal hysterectomy.  Conclusion: Systemic single dose MTX injection followed by D&amp;S is an effective and harmless management for CSP. Nevertheless more studies are required to prove the efficiency, safety, and reproductive outcome of variant modalities in treatment of CSP.

Single dose of Methotrexate therapy followed by suction curettage for management of Cesarean Scar Pregnancy