Cervical-isthmical pregnancy. A clinical case report
DOI:
https://doi.org/10.15574/PP.2025.4(104).111115Keywords:
cervicocervical pregnancy, treatment, ectopic pregnancy, placenta accretaAbstract
Ectopic pregnancy is a condition in which implantation and development of a fertilized egg occurs outside the uterine cavity and is one of the life-threatening conditions for a woman's life and reproductive health. In clinical gynecology, it is customary to distinguish distal forms of ectopic pregnancy (cervical and cervicocervical) and proximal forms (tubal, abdominal, ovarian). Cervical and cervicocervical pregnancy, among various variants of ectopic pregnancy, occurs with a frequency of between 1:8,600 and 1:12,400 cases of the total number of all pregnancies and less than 1% of the number of ectopic pregnancies.
Aim - based on a clinical case, analyze the difficulties of diagnosing cervicovaginal pregnancy to expand doctors' knowledge of this pathology.
A clinical case of cervicocervical pregnancy at 31 weeks of gestation, which ended with a cesarean section with a viable baby and extirpation of the uterus, is described. In a true cervical pregnancy, the fetal container is the cervical canal, and in a cervicocervical localization, the cervix and the isthmus area. Cervical pregnancy poses a threat to the woman's life: the main danger and cause of death in 75-85% of cases is profuse bleeding. A feature of this clinical case is that the diagnosis can be made only during delivery, due to the difficulties of clearly localizing implantation and imitating the clinical picture of placenta previa. A detailed description of the delivery is given, outlining the difficulties of access.
Conclusion. The presented clinical case is an illustration of a difficult-to-diagnose case, where a cervicocervical pregnancy imitates a uterine pregnancy with placenta previa. Practical recommendations for physicians regarding the choice of the site of uterine incision for fetal extraction are provided.
The study was performed in accordance with the principles of the Declaration of Helsinki. The patient's informed consent was obtained for the publication of the case report.
The authors declare that there is no conflict of interest.
References
Coulter-Nile S, Balachandar K, Ward H. (2022). A diagnostic dilemma of an 18-week cervical ectopic pregnancy: A case report. Case Reports in Women's Health. 33: e00385. https://doi.org/10.1016/j.crwh.2022.e00385; PMid:35198413 PMCid:PMC8841278
Dziedzic, JM, Patel PV. (2019). Cervical ectopic pregnancy: a rare site of implantation. J Emerg Med. 56(6): e123-e125. https://doi.org/10.1016/j.jemermed.2019.03.024; PMid:31003816
Evora F, Hundarova K, Aguas F, Carvalho G. (2021). Cervical Ectopic Pregnancy: A Multidisciplinary Approach. Cureus. 13(10): e19113. https://doi.org/10.7759/cureus.1911
Hosni MM, Herath RP, Mumtaz R. (2014). Diagnostic and therapeutic dilemmas of cervical ectopic pregnancy. Obstet Gynecol Surv. 69(5): 261-76. https://doi.org/10.1097/OGX.0000000000000062; PMid:25101692
Long Y, Zhu H, Hu Y, Shen L, Fu J, Huang W. (2020). Interventions for non-tubal ectopic pregnancy. Cochrane Database Syst Rev. 7(7): CD011174. https://doi.org/10.1002/14651858.CD011174.pub2; PMid:32609376 PMCid:PMC7389314
Rybalka AM, Pamfamirov YuK, Zabolotnov VO ta in. (2003). Osoblyvosti kliniky, diahnostyky ta dyferentsiinyi pidkhid do likuvannia shyikovoi vahitnosti. Reproduktyvne zdorov'ia zhinky. 4(16): 31-33.
Stabile G, Mangino FP, Romano F, Zinicola G, Ricci G. (2020). Ectopic Cervical Pregnancy: Treatment Route. Medicina (Kaunas). 56(6): 293. https://doi.org/10.3390/medicina56060293; PMid:32545627 PMCid:PMC7353881
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