Cervical Pregnancy Update and Clinical Experience

Cervical ectopic pregnancy is implantation of an embryo into the cervical mucosa below the level of the internal os. It accounts for less than 1 % of all ectopic pregnancies and one of the causes of maternal mortality in the first trimester. Cervical ectopic pregnancy may cause severe hemorrhage necessitating hysterectomy.usually made by transvaginal ultrasound that reveal an empty uterus, enlarged barrel shaped cervix containing a gestational sac present below the level of internal os. There is a lot of controversies about the best way for intervention of such conditions. Management depends on the clinical presentation and the duration of pregnancy. If sthe patient is hemodynamically stable and early in pregnancy, medical treatment with methotrexate is the therapy of choice. In unstable cases or failed medical management, surgical intervention is indicated. The risk of hemorrhage may be reduced by preoperative uterine artery embolization, transvaginal ligation of the cervical branches of the uterine arteries, cervical cerclage, intracervical vasopressin injection, intracervical balloon tamponade, internal iliac artery ligation up to hysterectomy.




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