Cervical Ectopic Pregnancy: A Clinician’s Dilemma

Uterine Artery Embolization and Methotrexate Infusion as Sole Management for Caesarean Scar and Cervical Ectopic Pregnancies: A Single-Center Experience and Literature Review

“…L'objectif de cette etude est d' evaluer les r esultats techniques et cliniques de l'embolisation art erielle ut erine (UEA) associ ee a la perfusion intraart erielle de m ethotrexate (MTX) pour le traitement de ces deux types de grossesse. Ectopic pregnancy is defined as implantation of the blastocyst outside the uterine cavity, and it occurs in 1.9% of reported pregnancies [1]. It is a life-threatening condition, so early diagnosis and rapid treatment are crucial to reducing the risk of maternal morbidity and mortality.…”

Cervical Ectopic Pregnancy: A Multidisciplinary Approach

“…Cervical pregnancy occurs when an embryo undergo nidation in the endocervical canal [ 3 ]. Any compromise in the capacity of the uterine cavity that prevents implantation in the endometrium could be a contributing factor [ 1 ]. The major risk factors include in vitro fertilization, endometrial injury caused by pelvic inflammatory disease or postsurgical trauma such as cesarean section or uterine curettage, history of abortions, intrauterine device use, and structural uterine anomalies [ 1 ].…”

“…Any compromise in the capacity of the uterine cavity that prevents implantation in the endometrium could be a contributing factor [ 1 ]. The major risk factors include in vitro fertilization, endometrial injury caused by pelvic inflammatory disease or postsurgical trauma such as cesarean section or uterine curettage, history of abortions, intrauterine device use, and structural uterine anomalies [ 1 ]. Although it is a rare condition, nowadays, the incidence seems to be rising not only due to assisted reproductive technologies but also thanks to better access and accuracy of transvaginal ultrasound scanning [ 4 , 5 ].…”

“…Cervical pregnancy can also be widely misdiagnosed as an ongoing abortion. The best way to distinguish the two situations is by the sliding sign, which means that when gentle pressure is applied on the cervix with the probe, the implanted cervical pregnancy does not slide, unlike the gestational sac of the abortion [ 1 ].…”

“…Cervical ectopic pregnancy is the rarest form of ectopic pregnancy, accounting for less than 1% of these cases, with an incidence of approximately 1/8628 to 1/10000 of all pregnancies [1][2][3]. It is associated with high morbimortality especially if there is a delay in diagnosis or treatment, as it can complicate with profuse hemorrhage, which can lead to hysterectomy with impairment of the woman's reproductive future or even death [4].…”