Cervical pregnancy

Objective: To present a case of successful management of a heavily bleeding cervical ectopic pregnancy with ultrasound-guided termination procedure of evacuation. Design: Case report. Setting: University hospital. Patient(s): A 34-year-old woman, secundigravida with one previous full-term natural childbirth and history of one spontaneous abortion, with a cervical pregnancy. Intervention(s): Prophylactic suture ligation of the cervicovaginal branches of the uterine artery, with absorbable sutures at the 3 and 9 o'clock positions of the cervix. Evacuation, with dilatation and curettage, under transabdominal ultrasound guidance was performed. Control of hemorrhage by placing a running-lock absorbable suture around the entire edge of the cervix followed by cervical packing with iodoform gauze medicated with anticoagulant drugs. Main Outcome Measure(s): Recovery of the patient, successful conservative treatment of the cervical ectopic pregnancy, with preservation of the uterus. Result(s): The cervical ectopic pregnancy was succesfully evacuated, and the reproductive capability of the patient was preserved. Conclusion(s): Ultrasound-guided evacuation with prophylactic closure of the cervical branches of the uterine artery and application of a running-lock suture around the cervix can be used in case of heavily bleeding cervical ectopic pregnancy. (Fertil Steril (R) 2011;95:2123.e3-e4. (C) 2011 by American Society for Reproductive Medicine.)