Abstract
This study is aimed at describing a noninvasive conservative strategy to the treatment of cervical pregnancy and highlighting the success of ultrasound-guided therapeutic techniques. A 43-year-old woman with a history of one previous cesarean section presented in our unit with vaginal spotting and a positive urine pregnancy test. She was diagnosed with a cervical pregnancy, and she was successfully treated conservatively with the administration of intragestational sac methotrexate under ultrasound guidance. Cervical pregnancy is a rare form of ectopic pregnancy that results from conceptus implantation in the cervical canal. The main concern is the associated life-threatening hemorrhage and subsequent need for urgent hysterectomy. The evolution of ultrasound over the past decades has enabled early diagnosis and has shifted the management from a radical surgical approach towards a stepwise conservative therapeutic approach, when possible.
Highlights
A cervical ectopic pregnancy occurs when a blastocyst implant in the endocervical canal
Diagnosis of cervical implantation is crucial for the subsequent management that should minimize the risk of hemorrhage, eliminate the gestational tissue, and spare fertility
There is no consensus about the appropriate treatment of cervical pregnancies, conservative management is preferred [2, 3] in asymptomatic or minimally symptomatic and hemodynamically stable patients, leaving more radical surgical approaches such as hysterectomy for unstable patients with life-threatening symptoms and/or failure of a conservative approach
Summary
A cervical ectopic pregnancy occurs when a blastocyst implant in the endocervical canal. Cervical pregnancies are relatively uncommon, and it is estimated that they account for less than one percent of all ectopic pregnancies [1]. This condition is rare, it has been associated with high morbidity due to the risk of major fatal hemorrhage. Diagnosis of cervical implantation is crucial for the subsequent management that should minimize the risk of hemorrhage, eliminate the gestational tissue, and spare fertility. Transvaginal ultrasound allows the diagnosis of cervical ectopic pregnancies at early stages, increasing the chances of success with medical treatment. We describe a case of cervical pregnancy which was successfully treated with ultrasoundguided intragestational sac methotrexate injection in our unit
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