Scar Ectopic Pregnancy"

A 32 years old G4P3L3 with previous 3 LSCS with 11 weeks amennorhea came with history of abortifacient intake twice from private doctor(no documents available) came for MTP. USG and MRI done s/o G-sac close to prev LSCS site Patient was taken up for 1st trimester MTP by suction and evacuation Intra-op, profuse bleeding noted. Immediate decision of exploratory laparotomy taken. Pffanenstiel incision taken and opened till rectus muscle. Muscle was densely adherent to uterus and adhesiolysis done. Obstetric hysterectomy done after consent and hemostasis achieved. HPE and gross appearance suggested scar ectopic. What are the challenges faced in diagnosis and management of such a case?