Cervical ectopic pregnancies account for less than 1% of all pregnancies. It may present with abnormal and occasionally heavy bleeding.

To understand the challenges associated with management of cervical ectopic pregnancies and learn to individualize the available treatment modalities for a successful outcome.

A 42-year-old woman, G6P2L2MTP3 with amenorrhea of 2 months, was diagnosed with cervical ectopic pregnancy of 9 weeks on ultrasonography. She was a known case of dilated cardiomyopathy with type II diastolic dysfunction and an ejection fraction of 25%. The patient was given systemic methotrexate followed by intra-amniotic methotrexate and fetal intracardiac potassium chloride. She was followed up with serial β-human chorionic gonadotropin (hCG) reports. However, she developed abdominal pain with bleeding per vaginum and ultrasonography suggestive of a hematoma. The patient was then taken up for a bilateral uterine artery embolization followed by an immediate suction evacuation. The products of conception sent for histopathology confirmed the microscopic diagnosis of cervical pregnancy.

It is a challenging clinical situation to diagnose and manage. It needs to be diagnosed early, and management needs to be individualized.

Even with advanced diagnostic modalities and reduction in current mortality rates, cervical pregnancy remains a life-threatening condition. It is of utmost importance to be thorough with the emerging trends in its management, as it comes with the promise of being unpredictably catastrophic.

Raza N, PaiDhungat NP. Successful Conservative Management of a Case of Cervical Ectopic Pregnancy complicated with Preexisting Cardiomyopathy. J South Asian Feder Obst Gynae 2017;9(4):356-359.