A diagnostic dilemma of an 18-week cervical ectopic pregnancy: A case report

Coulter-Nile, Sarah; Balachandar, Kapilesh; Ward, Harvey

doi:10.1016/j.crwh.2022.e00385

Cited by 5 publications

(6 citation statements)

References 9 publications

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“…The size of the foetus and its positioning within the endocervical canal makes imaging of the cervix and its relationship to the foetal head particularly difficult at more advanced gestation, making ultrasound of CEP prone to misinterpretation. 4 Preferably, ultrasonography CEP can be detected early and accurately with transvaginal sonography (TVS) and βHCG estimation. In a healthy pregnancy, the level of βHCG in the blood doubles in 48 hours.…”

Section: Discussionmentioning

confidence: 99%

Cervical Ectopic Pregnancy (CEP) – A Case Report

Saha¹,

Reddy²,

Prabha³

2022

IJPSRR

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Ectopic pregnancy is the implantation of fertilized ovum at an abdominal site. Cervical ectopic pregnancy is an extremely rare form of pregnancy where the implantation of the egg occurs. It usually presents with uncontrolled vaginal haemorrhage during the first trimester of pregnancy. It can be rarely found in the second trimester of pregnancy. The early diagnosis using ultrasonography methods likely transvaginal sonography and βhcg. In this case, 30 years old patient came to the hospital after taking MTP twice in a week and local examination showed a normal uterus and enlarged cervix and an antenatal scan revealed the gestational sac with a foetal pole and good cardiac activity within the lower uterine segment. Due to heavy vaginal bleeding for 2 weeks emergency laparotomy with bilateral tubectomy has been performed. Here we concluded that cervical pregnancy is a rare condition that can be fatal if not recognised and treated promptly. Chemotherapy administration may be the first line of therapy, but there may be a risk of excessive haemorrhage which may require a more radical approach done instantly.

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Section: Discussionmentioning

confidence: 99%

Cervical Ectopic Pregnancy (CEP) – A Case Report

Saha¹,

Reddy²,

Prabha³

2022

IJPSRR

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“…Будь-яка вагітність шийки матки, яка триває більше 12 тижнів, буде перевищувати внутрішній зів і буде класифікуватися як істмікоцервікальна, а не як первинна цервікальна вагітність. За словами Шнайдера і Драйзіна, така вагітність є більш небезпечною, ніж вагітність, пов'язана з шийкою матки, оскільки трофобласти з більшою ймовірністю руйнують кровоносні судини матки [5,13]. Тому діагностика цієї патології на ранніх термінах вагітності вважається основою адекватного лікування та збереження фертильності та життя жінки.…”

Section: вступunclassified

“…Варто зазначити, що буде підвищений ризик ушкодження сечовивідних шляхів через збільшену бочкоподібну шийку матки. S. Coulter-Nile et al (2022) повідомляють про унікальний випадок шийкової вагітності терміном 18 тижнів [5]. Жінка 27 років, звернулася до пологового відділення сільської лікарні на 18 тижні вагітності з передчасним розривом плодових оболонок.…”

Section: результати обговоренняunclassified

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Ectopic pregnancy of cervical localization: modern aspects of treatment

Lovkina¹,

Kosianenko²,

Klivak³

et al. 2022

Rep. of Vinnytsia Nation. Med. Univ.

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Annotation. A review of the scientific literature on the problem of diagnosis and modern methods of treatment of cervical pregnancy is presented. Ectopic pregnancy (ectopic pregnancy) is a condition in which the implantation and development of a fertilized egg takes place outside the uterine cavity and is one of the threatening conditions for life and reproductive health of women. Cases of cervical pregnancy occur with a frequency between 1:8 600 and 1:12 400 cases of the total number of all pregnancies and less than 1% of the number of ectopic pregnancies. Suspicion of a diagnosis of “cervical pregnancy” is an indication for immediate hospitalization of the woman in a gynecological hospital, a thorough examination and selection of treatment, because this pathology can provoke massive bleeding in the first trimester of pregnancy. In the practice of obstetrician-gynecologist for a long time there was one method of treatment of this pathology – extirpation of the uterus. To date, there are conservative and surgical treatments, that we will cover in this article. We conducted a systematic review and analysis of relevant literature sources, which have been published in the vast majority over the past 10 years (2012-2022), on modern methods of diagnosis and treatment of cervical pregnancy. The search was conducted in search databases PubMed, Google Scholar, Cochrane Library, Web of Science. The following search terms were used in the work: “cervical pregnancy”, “ectopic pregnancy”. It was found that the problem of treatment of cervical pregnancy remains relevant today, because there is no clear opinion on the best method of treatment. The decision to use one or another method is left to the attending physician, who must adequately assess the patient's condition, obstetric situation and possible options for prescribing appropriate treatment, the available methods were justified.

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“…It has been reported that more than half of patients with CEP (50.2%) required multiple interventions, and 9% underwent hysterectomy (HT). 4,5 The success of conservative treatment depends on the initial diagnostic accuracy, which may increase the chances of successful preservation of reproductive capability. 6 We had four patients with CEP and IM with the GS located at the level of the cervical canal who were clearly diagnosed on CEUS.…”

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confidence: 99%

The role of contrast‐enhanced ultrasound in the diagnosis and guiding therapy of early cervical ectopic pregnancy

Chen

2023

J of Clinical Ultrasound

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We described the ultrasonic imaging characteristics of four patients with cervical ectopic pregnancy (CEP) and inevitable miscarriage (IM) with the gestational sac (GS) located at the level of the cervical canal discussed and analyzed them in combination with relevant data, such as surgery and outcomes. It was found that contrast‐enhanced ultrasound (CEUS) could provide a more accurate differential diagnosis of early CEP and IM than conventional ultrasound (US), thus providing more effective guidance for clinical therapy. In CEP, CEUS shows sustained annular hyperenhancement of the GS wall. However, CEUS shows nonenhancement or pedicle‐like enhancement in IM with the GS located at the level of the cervical canal.

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A diagnostic dilemma of an 18-week cervical ectopic pregnancy: A case report

Cited by 5 publications

References 9 publications

Cervical Ectopic Pregnancy (CEP) – A Case Report

Cervical Ectopic Pregnancy (CEP) – A Case Report

Ectopic pregnancy of cervical localization: modern aspects of treatment

The role of contrast‐enhanced ultrasound in the diagnosis and guiding therapy of early cervical ectopic pregnancy

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