Abstract
Introduction: Cervico-isthmic pregnancy is rare, and serious because of its hemorrhagic complication. Its management varies according to the teams. Observation: We report a case of cervico-isthmic pregnancy on a cesarean scar. This is a 35-year-old, G2P2, who consulted for bleeding from the 1st trimester of pregnancy. The clinical examination found a minimal uterine bleeding. The diagnosis was made by a vaginal ultrasound which found a cervico-isthmic implantation of the pregnancy on the caesarean scar. A protocol of Mifepristone and Misoprostol followed by administration of a single dose of 1 mg/kg of Methotrexate was performed. Cure was obtained 1 month after treatment by negativation of plasma HCG. No bleeding complications were noted. A follow-up ultrasound performed 2 months later showed a uterine vacuity and the presence of an isthmocoele. It was in fact a pregnancy that had implanted in the isthmocoele. Conclusion: Cervico-isthmic pregnancy is rare. His treatment is not codified. Drug management was successful.
Highlights
Cervico-isthmic pregnancy is rare, and serious because of its hemorrhagic complication
Observation: We report a case of cervico-isthmic pregnancy on a cesarean scar
We report our experience in the management of a Cervical-isthmic pregnancy (CIP)
Summary
Cervical-isthmic pregnancy (CIP) is a rare form of ectopic pregnancy. It often occurs on caesarean scars, preferably multiple scars [1] [2]. Due to the increasing number of caesarean deliveries, the incidence of CIP varies from 1/1000 to 1/95,000 [3]. It is serious because of its hemorrhagic complication. Its management is very controversial about its evacuation technique. Through this observation, we report our experience in the management of a CIP
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