Cervical Ectopic Pregnancy, Challenging Diagnosis and Treatment; Case Series

Abstract

Cervical ectopic represents < 1% of all ectopic pregnancies. It’s a high-risk pregnancy and could result in life threatening haemorrhage if not timely diagnosed. Diagnosis itself is not an easy task, TVS and color Doppler imaging are important diagnostic tools, early diagnosis leads to early intervention and prevention of complications. Systemic or intra amniotic injection of methotrexate along with foleys ballon tamponade to control haemorrhage are economical options for conservative management. We are presenting an interesting case series of three patients with different treatment options, treated successfully. These patients were presented in Allied Hospital affiliated with Faisalabad Medical University, Faisalabad during 10-year period from 2008-2018. Our first case was G₄P₁A₁E₁ with one previous C section, one previous miscarriage and previous ectopic pregnancy presented at 9⁺¹ weeks gestation with viable fetus. She was treated with systemic and local intra-amniotic injection of methotrexate. Followup with β hCG discloses successful outcome. Second case was G₆P₃A₂ presented in emergency with torrential haemorrhage at 8⁺⁴ weeks of amenorrhea. Patient was treated by hysterectomy in emergency. Third patient was G₃P₂A₀ presented at 6⁺¹ weeks of amenorrhea with non-viable fetus, diagnosed on transvaginal scan and β HCG and treated successfully by systemic methotrexate.