Abstract
Introduction: Cervical ectopic pregnancy is extremely rare, accounting for less than 1% of all ectopic pregnancies. Its etiology is still unclear. However, there are reports of association with chromosomal abnormalities as well as a prior history of procedures that damage the endometrial lining such as cesarean section, intrauterine device, and in vitro fertilization.
Objective: To find out, to keep records & to follow-up of any rare disease and evaluate the cause of cervical haematoma
Case: A 35-year-old G3P2L2 with previous two lower segment caesarean sections, a referred case presented with complaint of painless excessive bleeding per vaginum for 7 days following menstrual regulation (MR). General examination revealed mild pallor with tachycardia and blood pressure of 100/60 mmHg. On gentle per vaginum examination revealed edematous, patulous cervix & closed external os with active bleeding. The case is reported here for its relative rarity.
Conclusion: Although considered rare, cervical ectopic pregnancy represents major threat due to its risk of major life threatening haemorrhages. Therefore, different methods of treatment were used ranging from hysterectomy up to conservative ones. Hysteroscopic resection has enabled us to remove the product of conception from cervix making the minimal damage to the local tissue, thus preserving fertility. Persisting pervaginal bleeding after menstrual regulation (MR) could be a rare cause of cervical ectopic pregnancy.
Keywords: Cervical pregnancy, hysteroscopy, menstrual regulation.
References
- Leeman LM, Wendland CL. Cervical ectopic pregnancy. Diagnosis with endovaginal ultrasound examination and successful treatment with methotrexate. Arch Fam Med. 2000;9:72–7.
- Cepni I, Ocal P, Erkan S, Erzik B. Conservative treatment of cervical ectopic pregnancy with transvaginal ultrasound-guided aspiration and single-dose methotrexate. Fertil Steril. 2004;81:1130–2.
- Gun, M., and M. Mavrogiorgis. "Cervical ectopic pregnancy: a case report and literature review." Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology19, no. 3 (2002): 297-301.
- Nahar, Kamrun, Turani Talukder, Sabiha Sultana, and Md Anwar Hossain. "Study on Risk Factors, Clinical Presentation & Operative Management of Ectopic Pregnancy." Bangladesh Journal of Obstetrics & Gynaecology28, no. 1: 9-14.
- Zabin F. Clinical presentation, management and operative findings of ectopic pregnancy DMCH, Dhaka. 1998; Dissertation.
- Singh, Sweta. "Diagnosis and management of cervical ectopic pregnancy." Journal of human reproductive sciences6, no. 4 (2013): 273.
- Visvalingam, Geetha, Ryan Wai Kheong Lee, TseYeun Tan, and Heng Hao Tan. "An Unusual Case of Acquired Uterine Arteriovenous Malformation With Persistent Scar Ectopic Pregnancy Successfully Managed With Uterine Artery Embolization." Journal of Medical Cases7, no. 4 (2016): 143-147.
- Leeman LM, Wendland CL. Cervical ectopic pregnancy. Diagnosis with endovaginal ultrasound examination and successful treatment with methotrexate. Arch Fam Med. 2000;9:72–7. [PubMed]
- Kung FT, Lin H, Hsu TY, Chang CY, Huang HW, Huang LY, et al. Differential diagnosis of suspected cervical pregnancy and conservative treatment with the combination of laparoscopy-assisted uterine artery ligation and hysteroscopic endocervical resection. Fertil Steril. 2004;81:1642–9. [PubMed]
Corresponding Author
Dr Farhana Haque
DOI: https://dx.doi.org/10.18535/jmscr/v7i4.09
