Cervical ectopic pregnancy: 10 year experience at tertiary care hospital and current literature review
Keywords:Cervical pregnancy, Ectopic pregnancy, Methotrexate, Mefiprestone, Expectant management
Background: Objective of the study was to critically analyze the clinical experience and literature on cervical pregnancy.
Methods: This is a retrospective analysis of cervical ectopic pregnancies (CEP) diagnosed in our tertiary care institute from 2005 to 2015 and literature search.
Results: In this study period the total numbers of births in our institute were 1, 32, 752, ectopic pregnancies were 307 and three cases of cervical ectopic pregnancies were diagnosed. Incidence of CEP at our institute is 0.9% of all ectopic pregnancies and 0.002% or 1 in 44,250 of livebirths which matches the available literature. The first two cases developed torrential haemorrhage which ended in hysterectomy and the third case was managed conservatively with methotrexate (MTX) and mefiprestone.Conclusions: The early detection of cervical pregnancy in asymptomatic or minimally symptomatic patients increases use of more conservative approaches which aim to preserve the uterus and the patient's reproductive potential. We suggest that systemic administration of low dose MTX is ideal for patients who are stable and if live embryo is detected, to reduce MTX failure rate concomitant feticide must be done, for which mefiprestone seems to be easy safe alternative to local chemotherapy.
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