DIAGNOSTIC CHALLENGE AND CONSERVATIVE MANAGEMENT OF CERVICAL PREGNANCY WITH UTEREUS PRESERVATION

  • Anita Morarcalieva Chochkova PHI General Hospital Gevgelija, North Macedonia
  • Marina Nakova PHI General Hospital Gevgelija, North Macedonia
  • Nevenka Velickova Faculty of Medical Sciences, University Goce Delcev, Stip, North Macedonia
  • Bashkim Ismaili SHGO Mother Theresa Chair, Skopje, North Macedonia
  • Blazhe Chochkov PHI General Hospital Gevgelija, North Macedonia

Abstract

 Cervical pregnancy is a rare form of ectopic pregnancy in which the embryo implants in the
lining of the endocervical canal. Clinical criteria and ultrasound features, supplemented by rapid assay of
serum human chorionic gonadotropin (hCG), make the diagnosis easier and more accurate. Depending on
the time of diagnosis and the patient’s condition, management can be conservative or operative
Case: We present a rare case of cervical pregnancy with all the diagnostic challenges for making
an early diagnosis and choosing the right treatment regimen, which can be life saving for the patients and
can reduce the chance of severe hemorrhage necessitating hysterectomy or blood transfusion
Early diagnosis, appropriate methotrexate regimen and combination of necessary adjuvant
conservative procedures could contribute to successful treatment with preservation of the uterus and
future reproductive ability.
Keywords: Cervical pregnancy, human chorionic gonadotropin, transvaginal ultrasound,
methotrexate, vaginal bleeding.


https://doi.org/10.55302/JMS2361093mch

References

1.Sivalingam N, Mak FK. Delayed diagnosis of cervical pregnancy: management options. Singapore Med J. 2000 Dec;41(12):599-601. PMID: 11296786.
2 .Антовска В, Стојовски М. Гинекологија. 2016. Култура-Скопје
3. Pandja M. A rare case of cervcal pregnancy. Indian Journal of Obstetrics and Gynecology Research. 2014. Available from: URL: https://orcid.org/0000-0003-4665-3069
4. Kim TJ, Seong SJ, Lee KJ, Lee JH, Shin JS, Lim KT, Chung HW, Lee KH, Park IS, Shim JU, Park CT. Clinical outcomes of patients treated for cervical pregnancy with or without methotrexate. J Korean Med Sci. 2004 Dec;19(6):848-52. doi: 10.3346/jkms.2004.19.6.848. PMID: 15608396; PMCID: PMC2816301.
5. Kung FT, Lin H, Hsu TY, Chang CY, Huang HW, Huang LY, Chou YJ, Huang KH. 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 Jun;81(6):1642-9. doi: 10.1016/j.fertnstert.2003.11.034. PMID: 15193489.
6. Samal SK, Rathod S. Cervical ectopic pregnancy. J Nat Sci Biol Med. 2015 Jan-Jun;6(1):257-60. doi: 10.4103/0976-9668.149221. PMID: 25810679; PMCID: PMC4367055.
7. Vela G, Tulandi T. Cervical pregnancy: the importance of early diagnosis and treatment. J Minim Invasive Gynecol. 2007 Jul-Aug;14(4):481-4. doi: 10.1016/j.jmig.2006.11.012. PMID: 17630167.
8. Berek JS. Berek & Novak’s Gynecology 14th ed. 2007. Wolters Kluwer
Published
2023-05-10
How to Cite
MORARCALIEVA CHOCHKOVA, Anita et al. DIAGNOSTIC CHALLENGE AND CONSERVATIVE MANAGEMENT OF CERVICAL PREGNANCY WITH UTEREUS PRESERVATION. Journal of Morphological Sciences, [S.l.], v. 6, n. 1, p. 93-97, may 2023. ISSN 2545-4706. Available at: <https://jms.mk/jms/article/view/vol6no1-12>. Date accessed: 27 feb. 2024.
Section
Articles