Three-Dimensional Ultrasonographic Diagnosis of a Cervical Pregnancy

Ruano, Rodrigo; Reya, Fabien; Picone, Olivier; Chopin, Nicolás; Pereira, Pedro Paulo; Benachi, Alexandra; Zugaib, Marcelo

doi:10.1590/s1807-59322006000400014

Cited by 12 publications

(12 citation statements)

References 21 publications

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“…The specificity of three -dimensional (3D) ultrasound imaging has been reported to be better than two dimentional (2D) scans as the 3D image incorporates an additional coronal section that is not possible with 2D imaging. 13 Magnetic Resonance Imaging (MRI) is helpful in doubtful cases as tissue characterization is better with MRI when compared with ultrasound. 12 Treatment choices for cervical ectopic pregnancy may be divided into five categories 4 temponade with folys catheter, reduction of blood supply, surgical excision of trophoblast, intra amniotic feticide, (potassium chloride and/or methotrexate.)…”

Section: Discussionmentioning

confidence: 99%

Medical Management of Cervical Ectopic Pregnancy

Arif¹,

Mukhtar²,

Naheed³

et al. 2016

Annals KEMU

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Cervical ectopic pregnancy is a rare condition with implantation in the endocervical canal below the closed internal os. It accounts for less than 1% of all ectopic pregnancies. It is associated with high morbidity and mortality. A case of cervical ectopic pregnancy is reported. She was a young nulliparous female, timely referred from peripheral hospital. She was treated successfully with medical management and thus fertility was preserved.

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Section: Discussionmentioning

confidence: 99%

Medical Management of Cervical Ectopic Pregnancy

Arif¹,

Mukhtar²,

Naheed³

et al. 2016

Annals KEMU

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“…There are many predisposing factors for cervical pregnancy, such as intrauterine procedures, intrauterine insemination, in vitro fertilization (3), pelvic inflammatory disease, leiomyoma, intrauterine devices, and primary embryo anomaly; however, the cause of cervical pregnancy remains unknown (4).…”

Section: Discussionmentioning

confidence: 99%

“…The main US criteria, cited by Ruano et al (4), are gestational sac in the cervix, empty uterine cavity, dilated cervix, and normal uterine size (excluding the alternative possibility of spontaneous abortion in progress). Transabdominal and transvaginal sonographic examinations allow for a diagnosis that is easy and fast, two important characteristics in such a serious disease.…”

Section: Discussionmentioning

confidence: 99%

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Conservative treatment of a twin cervical pregnancy with uterine artery embolization

Farhat

Salah²,

Askri³

et al. 2008

Diagn Interv Radiol

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248C ervical pregnancy is a rare form of ectopic pregnancy, which accounts for about 0.1% of such pregnancies (1). The diagnosis of cervical pregnancy is difficult and commonly delayed. It is made in the majority of cases in the presence of massive blood loss, necessitating an emergency hysterectomy in about 50% of cases (2). Cervical pregnancy has a high morbidity potential because of hemorrhage. However, mortality has decreased because of early ultrasonographic diagnosis and new treatment options to prevent life-threatening bleeding.In this report, we present our successful experience with preoperative embolization of the uterine artery. Case reportA 41-year-old gravida 2 para 1 woman presented to the emergency department with amenorrhea for 11 weeks and painless vaginal spotting for 2 days. She was treated for threatened abortion by a progestative agent. Her obstetrical history was significant for a lower-segment cesarean section because of severe preeclampsia. She had no previous intrauterine procedures, pelvic inflammatory disease, or intrauterine devices. Her medical and surgical history were otherwise unremarkable.Four days after her initial visit, she presented to our obstetrical emergency service for persistence of painless vaginal spotting and dizziness. Clinical examination showed stable vital signs, and her abdomen was soft and nontender. Gynecological examination revealed a slightly enlarged uterus without adnexal masses. Vaginal examination revealed an anterior position of the cervix, which was extremely thin, with the external os closed; speculum examination showed a small amount of cervical bleeding. Hemoglobin was 12 g/dL and hematocrit was 34.2%.Transabdominal and transvaginal ultrasound (US) examinations confirmed the presence of a cervical twin pregnancy with two gestational sacs. One sac contained a live fetus with a 40 mm crown-rump length (CRL); the other contained a fetus with a CRL of 31 mm and no cardiac activity. Magnetic resonance imaging (MRI) was performed to improve diagnostic accuracy. It confirmed the cervical implantation of two gestational sacs and showed a fine cervical myometrium (Fig. 1).To preserve fertility, conservative treatment was proposed to the patient. Treatment was initiated by intraamniotic injection of potassium chloride guided by US to stop fetal heartbeat. Cardiac activity stopped immediately after injection. The following day, the patient underwent percutaneous catheterization of the femoral artery (5 F catheter) under local anesthesia. The selective uterine artery angiograms showed that the embryonic vessels were filled predominantly from the left side uterine artery (Fig. 2). We started by embolizing left uterine artery. Embolization was performed with resorbable particles mixed with diluted contrast material. This mixture was injected until the uterine arterial flow ABSTRACT Cervical pregnancy is a rare form of ectopic pregnancy. Its treatment has been described by different authors. We report our successful experience of a cervical twin pregnancy that was ...

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“…Servikal ektopik gebelik yönetiminde gestasyonel yaş, uterin artere olan yakınlığına göre gestasyonel kesenin lokalizasyonu, trofoblastların invazyonu ve bhcg değeri önemlidir (17,18) . Servikal ektopik gebeliğin tedavisinde medikal, cerrahi ve kombine tedaviler uygulanabilir.…”

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