A rare case of cervical ectopic pregnancy: complicated by haemorrhagic shock

Abstract

Cervical ectopic pregnancy is a rare condition that accounts for less than 0.1% of all ectopic pregnancies with high morbidity and mortality rate. We present a case of a 25 years old G5P3L2A1D1 with history of 9 weeks amenorrhoea and previous 3 caesarean sections (CS) presented with bleeding per vaginum for 2 days. Ultrasound examination revealed a ballooned-out cervical canal with a gestational sac containing foetus with cardiac activity present and an empty uterus with thickened endometrium with a typical hour-glass configuration of the uterus. Thus, the diagnosis of cervical ectopic pregnancy was made. Patient was complicated by haemorrhagic shock. Immediately hysterectomy was performed. Inj. PCV 4 unit and FFP 6 units were given and post-op- patient was shifted to ICU on ventilation support. In ICU, patient was kept on ventilation support for 4 days with vasopressor supports. Antibiotics, antacids, antiemetics, IV fluids, supportive care given. Patient was discharged on post-op day-7 with stable hemodynamics and healthy vaginal vault and stitch line. Improved ultrasound resolution and earlier detection has led to the development of more conservative treatments in non-severe cases that attempt to limit morbidity and preserve fertility.