Cervical pregnancy as a possible sequela of induced abortion. Report of 19 cases

The conservative management of cervical ectopic pregnancies

“…with fetal cardiac activity at presentation): a median of 129 days compared with a median of 43 days. The median number of blood tests to measure serum hCG for each woman was 12 (range, [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] and the median number of scans during the period of follow-up was 4 (range, 2-8).…”

“…Damage to the cervix and endometrial lining during operative uterine procedures has also been implicated 12 . Risk factors include previous surgical termination of pregnancy and Asherman's syndrome 13,14 . Cervical ectopic pregnancies have also been associated with assisted reproductive techniques including both intrauterine and intrafallopian tube embryo transfers 15,16 .…”

Cervical Ectopic Pregnancy: A Puzzling Event

“…Although the exact etiology of cervical ectopic pregnancy was unknown, but the probable predisposing factors are accelerated migration of fertilized ovum to the cervical canal before it is capable of nidation, damage of the endocervical canal due to previous instrumentation e.g prior dilation and curettage, PID,anatomical anomalies (myomas, synaechiae), use of intrauterine device,in vitro fertilization (IVF), diethylstilbesterol exposure is the another factor [4][5][6][7] . Classically these patients presents with first trimester per vaginal bleeding, with or without abdominal pain, pelvic pain, haemorrhagic mass, a gestational sac with the presence of an embryo with or without cardiac activity 8 .…”

Fertility-Preserving Surgery for Cervical Ectopic Pregnancy, from Past to Present

“…Shinagawa, in his 10 years of experience, reported in 1969 about 19 cervical pregnancy cases, all of which resulted in abdominal hysterectomy after attempted vaginal treatment to save the uterus. He expressed his surprise for the discrepancy in the frequency of cases between the United States and Japan [12]. In the United States, a little over 80 cases had been reported up until 1967 [13].…”

“…Sheldon et al experienced two cases at the Mayo Clinic over a 15-year period, an incidence of approximately 1 in 16,000 pregnancies [7], while Paalman and McElin found only five cases in a series of 47,974 pregnancies at two American hospitals over a 10-year period-an incidence of 0.01% [14]. On the other hand, in Japan, in addition to Shinagawa's 19 cases of approximately 19,000 pregnancies reported at his university hospital and affiliated hospitals between 1958 and 1967, at least 119 cases had been reported throughout Japan between 1953 and 1967 [12], suggesting the estimated incidence of the cervical ectopic pregnancy in Japan to be 0.1% (1:1000 pregnancies). Considering that no nulliparous woman was in his series and in 13 of the 19 cases of antecedent pregnancy were interrupted artificially, Shinagawa supposed that the difference in incidence was due to the higher number of legal abortions at that time in Japan.…”