A rare case series on cervical pregnancy

Abstract

Introduction: Cervical ectopic pregnancy is a rare life threatening condition that implants in the endocervical lining, accounting for less than 1% of all ectopics. Aim: Successful diagnosis, management and challenges of cervical pregnancy. Study Design: A case series on 5 cases of cervical pregnancy in SRMC, Chennai, their timely diagnosis, associated risk factors (previous surgeries, ART) and management modalities - foleys tamponade, Multi dose methotrexate regimen, suction and evaluation with or without UAE. Results: The mean gestational age of diagnosis was seven weeks. The median serum human chorionic gonadotropin level was 11 300 IU/L (range 610 to 163 700). Fetal cardiac activity was present in 1 case. Vaginal bleeding was the most common presentation. All cases were successfully managed conservatively, thus allowing uterine preservation. Systemic methotrexate (multi-dose protocol) was the mainstay of therapy. Other minimally invasive interventions included ultrasound-guided injection of potassium chloride into the pregnancy, uterine artery embolization, and dilatation and curettage, with Foley catheter tamponade. Conclusion: Cervical pregnancy has become not so rare now with risk factors like high caesarian rate and ART. Hence, timely diagnosis by ultrasound and effective management reduces the risk of severe life threatening hemorrhage or hysterectomy.