DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20183356

Twin cervical pregnancy: a unique case report

Karthik Chandra Bassetty, Rina Dutta Ahmed, Mukesh Fogla

Abstract


Cervical ectopic pregnancy is implantation of an embryo into the cervical mucosa below the level of the internal os. Cervical pregnancy is an infrequent form of ectopic gestation both in naturally conceived pregnancies and even after assisted reproductive technology (ART). It accounts for less than 1% of all ectopic pregnancies. The diagnosis can be missed as a case of incomplete abortion unless an experienced sonologist performs a transvaginal ultrasound. Management options vary and depend on the gestational age at diagnosis, general condition of the patient and woman’s desire to maintain fertility. Medical treatment with methotrexate is the therapy of choice in early gestation with hemodynamically stable patient. Surgical intervention is indicated in late gestation, unstable cases or failed medical treatment. At times hysterectomy is elected as the final path when bleeding does not subside. We present an unique case of twin cervical ectopic pregnancy managed initially conservatively later surgical management was undertaken in view of bleeding.


Keywords


Cervical pregnancy, Methotrexate, Suction evacuation, Twin

Full Text:

PDF

References


Ushakov FB, Elchalal U, Aceman PJ, et al. Cervical pregnancy: past and future. Obstet Gynecol Surv 1997;52:45-59.

Varghese U, Fajardo A, Gomathinayagam T. Brief Communication Cervical pregnancy. Oman Medical Journal. 2008;23(1).

Fritz and Speroff.Ectopic pregnancy.In:Clinical Gynecologic Endocrinology and Infertility – Marc A Fritz and Leon Speroff.8th edition.2017;1383

Berek JS. Nontubal ectopic pregnancy. In: Berek and Novak’s Gynecology. 15th ed. 2012:642-3.

Jurkovic D, Hacket E, Campbell S. Diagnosis and treatment of early cervical pregnancy: a review and a report of two cases treated conservatively. Ultrasound Obstet Gynecol. 1996;8:373-80.

Chrestiana D, Cheng AB, Panebianco NL, Dean AJ. Pitfalls in cervical ectopic pregnancy diagnosis by emergency physicians using bedside ultrasonography. Am J Emerg Med. 2014;32(4):397-1.

LM. Leeman, CL. Wendland, Cervical ectopic pregnancy: diagnosis with endovaginal ultrasound examination and successful treatment with methotrexate,” Arch Family Med. 2000;9(1):72-7.

FT. Kung, SY. Chang, Efficacy of methotrexate treatment in viable and nonviable cervical pregnancies. American J Obstet and Gynecol. 1999;181(6):1438-44.

TH Hung, WY Shau, TT Hsieh, JJ Hsu, YK Soong, CJ. Jeng. Prognostic factors for an unsatisfactory primary methotrexate treatment of cervical pregnancy: a quantitative review. Human Reproduction. 1998;13(9):2636-42.

Lawrence M Leeman, Claire L, Wendland.Cervical ectopic pregnancy: Diagnosis with endovaginal ultrasound examination and successful treatment with methotrexate. Arch Fam Med. 2000;9:72-7.

Jurkovic D,Hacket E,Campbell S.Diagnosis and treatment of early cervical pregnancy.Ultrasound Obstetr Gynecol 1996;8:373-80.