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).

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