Treatment of Cervical Pregnancy with Ultrasound-Guided Intragestational Injection of Methotrexate: A Case Report

This study is aimed at describing a noninvasive conservative strategy to the treatment of cervical pregnancy and highlighting the success of ultrasound-guided therapeutic techniques. A 43-year-old woman with a history of one previous cesarean section presented in our unit with vaginal spotting and a positive urine pregnancy test. She was diagnosed with a cervical pregnancy, and she was successfully treated conservatively with the administration of intragestational sac methotrexate under ultrasound guidance. Cervical pregnancy is a rare form of ectopic pregnancy that results from conceptus implantation in the cervical canal. The main concern is the associated life-threatening hemorrhage and subsequent need for urgent hysterectomy. The evolution of ultrasound over the past decades has enabled early diagnosis and has shifted the management from a radical surgical approach towards a stepwise conservative therapeutic approach, when possible.

Successful Management of Three Consecutive Cervical Pregnancy in the Same Patient- a Case Report

Ectopic cervical pregnancy is an infrequent complication of the early gestation. Despite tremendous development in the management of ectopic pregnancy, there still lies dilemma in the diagnosis and management of cervical ectopic pregnancy. Traditionally dilation and evacuation has been used in the successful management of these kind of ectopic gestation. In this case report we describe an uncommon case of recurrent ectopic pregnancy and subsequent management.

Effect of Uterine Arterial Chemoembolization Combined with Ultrasound-Guided Uterine Curettage on Cervical Pregnancy and Influencing Factors

This is a retrospective study to analyze the efficacy of uterine artery chemoembolization (UACE) combined with ultrasound-guided curettage in the treatment of cervical pregnancy and the factors affecting the postoperative outcome. A total of 26 subjects were included in the study and were divided into a control group of 12 and an observer group of 14, all patients with cervical pregnancy diagnosed in our hospital from January 2016 to January 2020. Patients in the control group were treated with methotrexate injection (MTX) combined with ultrasound-guided curettage in our hospital, while the observer group was treated with UACE combined with ultrasound-guided curettage. The efficacy of the two groups was evaluated at 3 months postoperatively, and data on patients’ age, days of menopause, pregnancy frequency, and vaginal bleeding were collected retrospectively. Intraoperative bleeding, time to recovery of serum human chorionic gonadotropin (HCG), hospitalization time, time to return to normal menstruation, time to disappearance of gestational sac, pregnancy frequency, presence of endometrial inflammation, gestational week, maximum diameter of gestational sac, thinnest myometrium, endogenous-exogenous type, gestational sac size, and HCG level were recorded in both groups. Single-factor analysis and multifactor logistic regression models were used to analyze the factors influencing the surgical outcomes of patients. The results of the study showed that the overall efficiency of the observer group was significantly higher than that of the control group, while intraoperative bleeding, hospital stay, time to return to normal menstruation, and time to disappearance of the gestational sac were all lower than those of the control group ( p < 0.05 ). The results of univariate and multifactorial analyses showed that endometrial inflammation, gestational week, maximum diameter of the gestational sac, thinnest myometrium, and endogenous-exogenous type could affect the patients’ postoperative recovery ( p < 0.05 ); gestational week, maximum diameter of the gestational sac, and thinnest myometrium were independent factors affecting the patients’ postoperative recovery ( p < 0.05 ). The above results suggest that UACE combined with ultrasound-guided uterine clearance for cervical pregnancy can significantly improve treatment efficacy, reduce intraoperative bleeding, and improve recovery time from postoperative related symptoms. The treatment efficacy of patients with cervical pregnancy was related to the gestational week, the maximum diameter of the gestational sac, and the thinnest muscle layer.

Rare uterine didelphis and cervical pregnancy

Due to increased vaginal bleeding, a surgical operation was performed on a woman with cervical pregnancy. A diagnosis of uterine didelphis (UD) was made during surgery. The hypogastric arteries on both sides were ligated. After controlling the bleeding, the 3Department of XXX, University of XXX, XXX Training and Research Hospital, City, Country abdomen was closed. Uterine defects are a rare malformation that can cause a variety of obstetric problems in pregnant women, and 4Department of XXX, Faculty of XXX, City, Country they must be closely monitored and treated in terms of cervical pregnancy growth. As the pregnancy week continues, life-threatening bleeding may occur, and the patient may need a hysterectomy to stop the bleeding.

The importance of early recognition of the so-called. cervical pregnancy highlights

The differential diagnosis between uterine abortion and cervical pregnancy is easily made on the basis of an internal study - in the first case, the examining finger easily penetrates between the cervical wall and the egg in it, while in the second case, the finger finds an intimate connection of the placenta with the cervical wall.