{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T14:44:30Z","timestamp":1776177870279,"version":"3.50.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"1197","license":[{"start":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T00:00:00Z","timestamp":1735257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,22]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n On the second day of my clinical observership in the Obgyn Department of the Vienna University Hospital, I saw a suspected case of caesarean scar pregnancy on follow-up, with one of my very senior professors, in the gynaecology outpatient clinic.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The 29-year-old multigravida with a previous caesarean section had earlier presented to the emergency room with vaginal bleeding at 7 weeks of gestation.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Ultrasound scan revealed a non-viable low-lying gestational sac located near the caesarean section scar, with a myometrial thickness of 0.96 cm. There was minimal vascular flow during the Doppler interrogation. Her quantitative serum beta-human chorionic gonadotropin was 687 IU\/l at presentation. This had dropped to 344 IU\/l after 48 h, with a further drop to 39 IU\/l after a week. Repeat ultrasound scan 1 week after revealed an empty uterus with no visible gestational sac, and vaginal bleeding had resolved. My professor made a final diagnosis of a spontaneous complete abortion.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n On reflection, this experience further reinforced the diagnostic dilemma that many clinical conditions can present, the need for a high index of suspicion in diagnosing and differentiating clinical conditions that present similar features, as well as the need for younger clinicians to leverage the better knowledge and experience of more senior colleagues to unknot knotty clinical dilemmas.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/postmj\/qgae189","type":"journal-article","created":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T00:01:53Z","timestamp":1735257713000},"page":"662-665","source":"Crossref","is-referenced-by-count":1,"title":["Abortion in evolution, caesarean scar pregnancy, and cervical ectopic: discerning the triplets on ultrasound"],"prefix":"10.1093","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7543-0510","authenticated-orcid":false,"given":"Akaninyene Eseme","family":"Ubom","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Vienna University Hospital\/Medical University of Vienna , W\u00e4hringer G\u00fcrtel 18-20, 1090 Vienna ,","place":["Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Engelbert","family":"Hanzal","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Vienna University Hospital\/Medical University of Vienna , W\u00e4hringer G\u00fcrtel 18-20, 1090 Vienna ,","place":["Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petra","family":"Kohlberger","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Vienna University Hospital\/Medical University of Vienna , W\u00e4hringer G\u00fcrtel 18-20, 1090 Vienna ,","place":["Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,12,27]]},"reference":[{"key":"2025062421122557800_ref1","doi-asserted-by":"publisher","first-page":"245","DOI":"10.48095\/cccg2022245","article-title":"Cesarean scar pregnancy-a retrospective analysis of cases in the years 2012-2021","volume":"87","author":"Ji\u0159\u00ed","year":"2022","journal-title":"Ceska Gynekol"},{"key":"2025062421122557800_ref2","doi-asserted-by":"publisher","first-page":"322","DOI":"10.30442\/ahr.0703-11-142","article-title":"Fertility-preserving Management of Cervical Ectopic Pregnancy in a Nigerian teaching hospital: medical management of cervical ectopic pregnancy","volume":"7","author":"Awowole","year":"2021","journal-title":"Ann Health Res"},{"key":"2025062421122557800_ref3","doi-asserted-by":"publisher","first-page":"257","DOI":"10.4103\/0976-9668.149221","article-title":"Cervical ectopic pregnancy","volume":"6","author":"Samal","year":"2015","journal-title":"J Nat Sci Biol Med"},{"key":"2025062421122557800_ref4","doi-asserted-by":"publisher","first-page":"1658","DOI":"10.1016\/S0140-6736(21)00682-6","article-title":"Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss","volume":"397","author":"Quenby","year":"2021","journal-title":"Lancet"},{"key":"2025062421122557800_ref5","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/S0015-0282(97)81930-9","article-title":"An ectopic pregnancy developing in a previous caesarian section scar","volume":"67","author":"Godin","year":"1997","journal-title":"Fertil Steril"},{"key":"2025062421122557800_ref6","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1007\/s13224-015-0817-3","article-title":"Scar ectopic pregnancy","volume":"65","author":"Patel","year":"2015","journal-title":"J Obstet Gynecol India"},{"key":"2025062421122557800_ref7","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1016\/0002-9378(59)90366-7","article-title":"Cervical pregnancy; 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