To evaluate the clinical efficacy of selective fetal reduction in the first trimester for the treatment of intrauterine pregnancy combined with cesarean scar pregnancy (CI-CSP), this article reports a 41-year-old pregnant woman diagnosed with CI-CSP after assisted reproductive technology. At 6 + weeks of gestation, mechanical fetal reduction surgery was performed under ultrasound guidance to eliminate the fetus at the scar site, and the fetal reduction was successful. The pregnancy lasted until 38 weeks of gestation. A healthy male infant was delivered by cesarean section. This case suggests that selective fetal reduction surgery can be a feasible option to preserve intrauterine pregnancy and reduce the risk of CI-CSP, but the indications and perioperative management need to be strictly controlled.

To evaluate the clinical efficacy of selective fetal reduction in the first trimester for the treatment of intrauterine pregnancy combined with cesarean scar pregnancy (CI-CSP), this article reports a 41-year-old pregnant woman diagnosed with CI-CSP after assisted reproductive technology. At 6 + weeks of gestation, mechanical fetal reduction surgery was performed under ultrasound guidance to eliminate the fetus at the scar site, and the fetal reduction was successful. The pregnancy lasted until 38 weeks of gestation. A healthy male infant was delivered by cesarean section. This case suggests that selective fetal reduction surgery can be a feasible option to preserve intrauterine pregnancy and reduce the risk of CI-CSP, but the indications and perioperative management need to be strictly controlled.