Successful conservative management in cervical Ectopic Pregnancy

Khurram Ahmad,Tahira Bashir Solehria

doi:10.21649/akemu.v10i3.2431

Abstract

Incidence of cervical ectopic pregnancy is 6% of all the ectopic pregnancies. And this percentage is rising since last decade with increased incidence of ectopic pregnancies in general. Assisted reproduction, tubal pathology due to pelvic inflammatory disease or/and adhesions due to surgery are leading causes for increased incidence of ectopic pregnancy. Modern diagnostic techniques and regular follow up in assisted reproduction cases, pick up ectopic pregnancy at an earlier gestation. Previously hysterectomy was the only resort in majority if not all the cases of cervical ectopic pregnancies But now in selective cases like saving fertility in a patient a promising management has emerged It is however emphasized that appropriate treatment option - medical or surgical should be considered according to individual case. This case of ectopic cervical pregnancy at 6 weeks of gestation is managed successfully by conservative management.

Highlights

She was shifted from another hospital with referral position after draping and per-speculum vaginal letter of the consultant .Who wrote that this patient is examination was done .Vagina was full of clots, which diagnosed as a case of cervical ectopic pregnancy on were removed showing moderate bleeding through the ultrasonography and color Doppler .Beta HCG was 56000 external os
On bimanual international units .Since with this diagnosis she was vaginal examination, external os was open but internal os bleeding mild to moderate they planned for hysterectomy
Patient was shifted to surgical ICU for strict monitoring for laparotomy for possible need of hysterectomy with 24 hours .Further plan was to proceed for laparotomy if diagnosis of cervical ectopic pregnancy

Summary

Introduction

Incidence of cervical ectopic pregnancy is 6% of all the ectopic pregnancies. And this percentage is rising since last decade with increased incidence of ectopic pregnancies in general. .Plasma expander infusion was started while the bleeding .She was 6 weeks and 4 days of gestational age arrangement for more units of blood was in process. Her current pregnancy was consultant was informed and called, fresh planned and spontaneous .She had regular menstrual cycle frozen plasma, packed RBCs and cryoprecipitate 6 units before and was neither lactating nor on any contraceptives.

Results

Conclusion