Conservative management of dehiscent scar discovered in the second trimester: A case report

Dehiscent scars and hematomas occurring on previous cesarean scars during pregnancy are uncommon. This situation poses a significant risk to both maternal and fetal health. This case report involves a 32-year-old woman, Gravida 3 Para 2, with two previous cesarean sections, who arrived at the emergency department at 25 weeks and 2 days of gestation, reporting lower abdominal pain. Upon examination, mild tenderness was noted in the right lower quadrant. An ultrasound revealed a hematoma measuring 8.4cm x 3.3cm, indicative of a dehiscent scar, which MRI confirmed. The patient was admitted for careful observation, and routine ultrasounds showed a reduction in the hematoma size, leading to the decision to extend the pregnancy. The initial dose of Dexamethasone was given and subsequently completed. An emergency cesarean section was conducted at 34 weeks and 2 days of gestation, resulting in the successful delivery of a healthy baby girl. The takeaway from this case is that not all cases of dehiscent scars require immediate termination and that conservative management plays a role.