Cervical pregnancy

The following ultrasound criteria may be used for the diagnosis of cervical ectopic pregnancy:

  1. an empty uterus,
  2. a barrel-shaped cervix,
  3. a gestational sac present below the level of the internal cervical os,
  4. the absence of the ‘sliding sign’ (when pressure is applied to the cervix using the probe, in a miscarriage, the gestational sac slides against the endocervical canal, but it does not in an implanted cervical pregnancy) and
  5. blood flow around the gestational sac using colour Doppler (Elson CJ et al., 2016).

Management strategies include systemic methotrexate, ultrasound-guided KCl injection, uterine artery embolism, curettage, ligation of cervical branches of the uterine arteries, paracervical infiltration with dilute vasopressin, and Foley catheter balloon tamponade (Murji A et al., 2015).

Cervical pregnancy
The doppler examination demonstrates heart activity.
Cervical pregnancy 2
After methotrexate treatment only doppler – negative, hypoechoic residue remained.

Bibliography

  • Elson CJ, Salim R, Potdar N, Chetty M, Ross JA, Kirk EJ on behalf of the Royal College of Obstetricians and Gynaecologists. Diagnosis and management of ectopic pregnancy. BJOG 2016;. 123:e15–e55.
  • Murji A., Garbedian K., Thomas J., Cruickshank B. Conservative management of cervical ectopic pregnancy. Journal of Obstetrics and Gynaecology Canada. 2015;37(11):1016–1020. doi: 10.1016/s1701-2163(16)30051-2

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.