Management of cervical heterotopic pregnancy with inevitable miscarriage

Authors

  • Shyamala R. Department of Obstetrics and Gynecology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
  • Saranya Srikumar Department of Obstetrics and Gynecology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
  • Radhamany K. Department of Obstetrics and Gynecology, Amrita Institute of Medical Sciences, Kochi, Kerala, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20190325

Keywords:

Cervical pregnancy, Chronic hypertension, Heterotopic pregnancy, Inevitable abortion, Non-stress test, Preeclampsia, Preterm LSCS

Abstract

The objective is to report a case of successful treatment of heterotopic cervical pregnancy resulting from IVF–ICSI conception. Case report from Amrita Institute of Medical sciences: a tertiary care referral hospital. A 47-year-old Primigravida, diagnosed with heterotopic cervical pregnancy at 6 weeks of gestation, presented with significant first trimester vaginal bleeding. Under IV sedation, Transvaginal ligation of descending cervical branches of the uterine arteries arrested the bleeding. The cervical pregnancy was successfully aborted with minimal bleeding and the intrauterine pregnancy was successfully maintained till 32 weeks, after which she required emergency preterm LSCS in view of Severe preeclampsia superimposed on chronic hypertension a non-reassuring non-stress test (NST). The intervention applied maybe used in treatment of heterotopic cervical pregnancy in a low resource setting to control the bleeding.

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References

DeVoe RW, Pratt JH. Simultaneous intrauterine and extrauterine pregnancy. Am J Obstet Gynecol. 1948;56(6):1119-26.

Fernandez H, Gervaise A. Ectopic pregnancies after infertility treatment: modern diagnosis and therapeutic strategy. Human Reprod Update. 2004;10(6):503-13.

Craciunas L, Tsampras N, Fitzgerald C. Cervical mucus removal before embryo transfer in women undergoing in vitro fertilization/intracytoplasmic sperm injection: a systematic review and meta-analysis of randomized controlled trials. Fertil Steril. 2014;101(5):1302-7.

Hafner T, Ivkosic IE, Serman A, Bauman R, Ujevic B, Vujisic S, et al. Modification of conservative treatment of heterotopic cervical pregnancy by Foley catheter balloon fixation with cerclage sutures at the level of the external cervical os: a case report. J Med Case Reports. 2010;4(1):212.

Tsakos E, Tsagias N, Dafopoulos K. Suggested method for the management of heterotopic cervical pregnancy leading to term delivery of the intrauterine pregnancy: Case report and literature review. J Minimally Invasive Gynecol. 2015;22(5):896-901.

Moragianni VA, Hamar BD, McArdle C, Ryley DA. Management of a cervical heterotopic pregnancy presenting with first-trimester bleeding: case report and review of the literature. Fertil Steril. 2012;98(1):89-4.

Faschingbauer F, Mueller A, Voigt F, Beckmann MW, Goecke TW. Treatment of heterotopic cervical pregnancies. Fertil Steril. 2011;95(5):1787-e9.

Ujvari E, Krizsa F, Sebestyen A, Varbiro S, Paulin F. Successful management of intrauterine twin and concomitant cervical pregnancy: a case report. Fetal Diagnosis Therapy. 2006;21(2):181-4.

Sijanovic S, Vidosavljevic D, Sijanovic I. Methotrexate in local treatment of cervical heterotopic pregnancy with successful perinatal outcome: case report. J Obstet Gynaecol Res. 2011;37(9):1241-5.

Chen D, Kligman I, Rosenwaks Z. Heterotopic cervical pregnancy successfully treated with transvaginal ultrasound-guided aspiration and cervical-stay sutures. Fertil Steril. 2001;75(5):1030-3.

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Published

2019-01-25

How to Cite

R., S., Srikumar, S., & K., R. (2019). Management of cervical heterotopic pregnancy with inevitable miscarriage. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 8(2), 779–782. https://doi.org/10.18203/2320-1770.ijrcog20190325

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Section

Case Reports