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Other diagnostic modalities are magnetic resonance imaging, hysteroscopy, laparoscopy or laparotomy.

Hysterectomy may be required because of the risk of uterine rupture and uncontrolled bleeding.

Diagnosis is difficult but transvaginal sonography and colour flow Doppler using the following criteria may be helpful[1].

• Visualization of an empty uterine cavity as well as an empty endocervical canal • Detection of the placenta and/or a gestational sac embedded in the hysterotomy scar • A thin or absent myometrial layer between the gestational sac and the bladder • A closed and empty cervical canal • The presence of embryonic or fetal pole or yolk sac with or without cardiac activity • The presence of prominent or rich vascular pattern in the area of caesarean scar.

She had history of one episode of sudden onset dull aching pain in lower abdomen which subsided on its own. She had history of abortifacient intake 4 days before.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.Access to society journal content varies across our titles.The reported incidence is 1/1800 to 1/2216 of all caesarean deliveries[2].The case reported here describes the use of intracardiac Potassium chloride, and intragestational sac and placental Methotrexate injection in a viable Caesarean scar pregnancy and its follow up.

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