A 32 years woman with previous 2 caesarean section presented to emergency department at late evening hours feeling unwell, dizziness and acute abdomen with unstable observations to a district general university hospital in London. After initial resuscitation she was diagnosed to have ruptured caesarean scar ectopic pregnancy with active bleeding and haemo-peritoneum. Patient had emergency laparotomy and repair of defect in the anterior uterine wall and conserved uterus with successful post op recovery.
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