Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 9 , ISSUE 4 ( October-December, 2017 ) > List of Articles

CASE REPORT

Successful Conservative Management of a Case of Cervical Ectopic Pregnancy complicated with Preexisting Cardiomyopathy

Naimah Raza, Nitin P PaiDhungat

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

DOI: 10.5005/jp-journals-10006-1528

License: CC BY 3.0

Published Online: 01-07-2016

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Background

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

Aim

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

Case report

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.

Conclusion

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

Clinical significance

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.

How to cite this article

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.


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  1. Cervical ectopic pregnancy: diagnosis with endovaginal ultrasound examination and successful treatment with methotrexate. Arch Fam Med 2000 Jan;9(1):72-77.
  2. Conservative treatment of cervical ectopic pregnancy with transvaginal ultrasound-guided aspiration and single-dose methotrexate. Fertil Steril 2004 Apr;81(4):1130-1132.
  3. Conservative treatment of cervical pregnancy by curettage and local prostaglandin injection. Hum Reprod 1997 Apr;12(4):860-866.
  4. Treatment of cervical pregnancy with cerclage, curettage and balloon tamponade. A report of three cases. J Reprod Med 2001 Jan;46(1):71-74.
  5. Recurrent ectopic pregnancy in a cesarean scar. Obstet Gynecol 2008 Feb;111(2 Pt 2):541-545.
  6. Diagnosis and treatment of early cervical pregnancy: a review and a report of two cases treated conservatively. Ultrasound Obstet Gynecol 1996 Dec;8(6):373-380.
  7. Three-dimensional ultrasonographic diagnosis of a cervical pregnancy. Clinics (Sao Paulo) 2006 Aug;61(4):355-358.
  8. MR imaging of the uterine cervix: imaging-pathologic correlation 1. Radiographics 2003 Mar;23(2):425-445.
  9. Efficacy of methotrexate treatment in viable and nonviable cervical pregnancies. Am J Obstet Gynecol 1999 Dec;181(6):1438-1444.
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