A 28 year old woman came with amenorrhea and bleeding per vaginum for two months. The urine pregnancy test was positive.
On trans-vaginal ultrasonography the uterus is retroverted. A gestational sac-like structure is seen in the anterior myometrium of the lower part of the uterine body at the site of the previous Cesarean section. It occupies more than half of the thickness of the myometrium. The myometrium overlying the sac is 2 mm thick. There is an echogenic rim with increased vascularity surrounding the sac. There is no yolk sac or fetal pole.