Introduction: Cervico-isthmic pregnancy is rare, and serious because of its
hemorrhagic complication. Its management varies according to the teams. Observation: We report a case of cervico-isthmic pregnancy on a cesarean scar. This is a
35-year-old, G2P2, who consulted for bleeding from the 1st trimester of
pregnancy. The clinical examination found a minimal
uterine bleeding. The diagnosis was made by a vaginal ultrasound which
found a cervico-isthmic implantation of the pregnancy on the caesarean scar. A
protocol of Mifepristone and Misoprostol followed by administration of a single
dose of 1 mg/kg of Methotrexate was performed. Cure was obtained 1 month after
treatment by negativation of plasma HCG. No bleeding complications were noted.
A follow-up ultrasound performed 2 months later showed a uterine vacuity and
the presence of an isthmocoele. It was in fact a pregnancy that had implanted
in the isthmocoele. Conclusion: Cervico-isthmic pregnancy is rare. His
treatment is not codified. Drug management was successful.
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