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Volume 17, Issue 7 (July 2019 2019)
IJRM 2019, 17(7): 521-524 |
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Mahdavi A, Aleyasin A, Sheibani N. Pre-curettage cerclage in a viable triplet
cervical pregnancy: A case report and review
of literature. IJRM 2019; 17 (7) :521-524
URL: http://ijrm.ir/article-1-1585-en.html
URL: http://ijrm.ir/article-1-1585-en.html
1- Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. , atossa_mahdavi@yahoo.com
2- Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
3- Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
2- Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
3- Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Abstract: (2480 Views)
Background: Cervical ectopic pregnancy (CEP) is a rare and dangerous form of ectopic pregnancy in which the blastocyst is installed within the endo-cervical canal. CEP diagnosis requires special awareness to evaluate patient precisely. Individualizing controversial medical and surgical management strategies is of importance in medical practice.
Case: A 35-year-old nulliparous woman on her 9th week of pregnancy was referred to our hospital with vaginal bleeding preliminary misdiagnosed as aborting intrauterine pregnancy. Transvaginal ultrasound revealed an empty uterus and a viable triplet pregnancy just below the level of internal os. Cervical curettage after cerclage suture placement procedure removed conception tissues completely. Consequently, in the next few hours vaginal bleeding decreased to minimal amount and vital signs remained within normal limits and there was no hematocrit change. On follow-up day 32, serum B-HCG became negative.
Conclusion: CEP diagnosis requires special attention and awareness to evaluate patient precisely along with skillful assessment of possible risk factors. Lifesaving treatment beside fertility preservation was successful with pre-curettage cerclage.
Case: A 35-year-old nulliparous woman on her 9th week of pregnancy was referred to our hospital with vaginal bleeding preliminary misdiagnosed as aborting intrauterine pregnancy. Transvaginal ultrasound revealed an empty uterus and a viable triplet pregnancy just below the level of internal os. Cervical curettage after cerclage suture placement procedure removed conception tissues completely. Consequently, in the next few hours vaginal bleeding decreased to minimal amount and vital signs remained within normal limits and there was no hematocrit change. On follow-up day 32, serum B-HCG became negative.
Conclusion: CEP diagnosis requires special attention and awareness to evaluate patient precisely along with skillful assessment of possible risk factors. Lifesaving treatment beside fertility preservation was successful with pre-curettage cerclage.
Type of Study: Short Research Reports |
References
1. Farqutar CM. Ectopic pregnancy. Lancet 2005; 366: 583-591. [DOI:10.1016/S0140-6736(05)67103-6]
2. Okunlola MA, Adesina OA, Adekunle AO. Repeat ipsilateral ectopic gestation- a series of 3 cases. Afr J Med Med Sci 2006; 35: 173-175.
3. Barntart KT. Clinical practice. Ectopic pregnancy. N Engl J Med 2009; 361: 379-387. [DOI:10.1056/NEJMcp0810384] [PMID]
4. Singh S. Diagnosis and management of cervical ectopic pregnancy. J Hum Reprod Sci 2013; 6: 273-276. [DOI:10.4103/0974-1208.126312] [PMID] [PMCID]
5. Karande VC, Flood JT, Heard N, Veeck L, Muasher SJ. Analysis of ectopic pregnancies resulting from in vitro fertilization and embryo transfer. Hum Reprod 1991; 6: 446-449. [DOI:10.1093/oxfordjournals.humrep.a137356] [PMID]
6. Vitale SG, Rapisarda AMC, Laganà AS. Cervical ectopic pregnancy: The role of hysteroscopy. Hysteroscopy 2017; 161-163. [DOI:10.1007/978-3-319-57559-9_18]
7. Hosni MM, Herath RP, Mumtaz R. Diagnostic and therapeutic dilemmas of cervical ectopic pregnancy. Obstet Gynecol Surv 2014; 69: 261-276. [DOI:10.1097/OGX.0000000000000062] [PMID]
8. Ginsburg ES, Frates MC, Rein MS, Fox JH, Hornstein MD, Friedman AJ. Early diagnosis and treatment of cervical pregnancy in an in vitro fertilization program. Fertil Steril 1994; 61: 966-969 [DOI:10.1016/S0015-0282(16)56714-4]
9. Yao M, Tulandi T. Practical and current management of tubal and nontubal ectopic pregnancies. Current Problems in Obstetrics, Gynecology and Fertility 2000; 23: 94-107.
10. Osada H, Teramoto S, Kaijima H, Segawa T, Miyauchi O, Nagaishi M, et al. A novel treatment for cervical and cesarean section scar pregnancies by transvaginal injection of absolute ethanol to trophoblasts: efficacy in 19 cases. J Minim Invasive Gynecol 2019; 26: 129-134. [DOI:10.1016/j.jmig.2018.04.021] [PMID]
11. Takeda K, Mackay J, Watts S. Successful management of cervical ectopic pregnancy with bilateral uterine artery embolization and methotrexate. Case Rep Emerg Med 2018; 2018: 9593824. [DOI:10.1155/2018/9593824] [PMID] [PMCID]
12. Timor-Tritsch IE, Monteagudo A, Bennett TA, Foley C, Ramos J, Kaelin Agten A. A new minimally invasive treatment for cesarean scar pregnancy and cervical pregnancy. Am J Obstet Gynecol 2016; 215: 351. e1-8. [DOI:10.1016/j.ajog.2016.03.010] [PMID]
13. Tanos V, ElAkhras S, Kaya B. Hysteroscopic management of cervical pregnancy: Case series and review of the literature. J Gynecol Obstet Hum Reprod 2019; 48: 247-253. [DOI:10.1016/j.jogoh.2018.05.001] [PMID]
14. Mashiach S, Admon D, Oelsner G, Paz B, Achiron R, Zalel Y. Cervical shirodkar cerclage may be the treatment modality of choice for cervical pregnancy. Hum Reprod 2002; 17: 493-496. [DOI:10.1093/humrep/17.2.493] [PMID]
15. Moragianni AV, Hamar BD, McArdle C, Ryley AD. Management of cervical heterotopic pregnancy presenting with first trimester bleeding: case report and a review of the literature. Fertil Steril 2012; 98: 89-94. [DOI:10.1016/j.fertnstert.2012.04.003] [PMID]
16. Hafner T, Ivkosic IE, Serman A, Bauman R, Ujevic B, Vujisic S, et al. Modification of conservative treatment of heterotopic cervical pregnancy by Foley catheter balloon fixation with cerclage sutures at the level of the external cervical os: a case report. J Med Case Rep 2010; 4: 212. [DOI:10.1186/1752-1947-4-212] [PMID] [PMCID]
17. Davies DW, Masson GM, McNeal AD, Gadd SC. Simultaneous intrauterine and cervical pregnancies after in vitro fertilization and embryo transfer in a patient with a history of a previous cervical pregnancy: case report. Br J Obstet Gynaecol 1990; 97: 634-637. [DOI:10.1111/j.1471-0528.1990.tb02554.x] [PMID]
18. Chen D, Kligman I, Rosenwaks Z. Heterotopic cervical pregnancy successfully treated with transvaginal ultrasound-guided aspiration and cervical stay sutures. Fertil Steril 2001; 75: 1030-1033. [DOI:10.1016/S0015-0282(01)01746-0]
19. Jozwiak EA, Ulug U, Akman MA, Bahceci M. Successful resection of a heterotopic cervical pregnancy resulting from intracytoplasmic sperm injection. Fertil Steril 2003; 79: 428-430. [DOI:10.1016/S0015-0282(02)04662-9]
20. Trojano G, Colafiglio G, Saliani N, Lanzillotti G, Cicinelli E. Successful management of a cervical twin pregnancy: neoadjuvant systemic methotrexate and prophylactic high cervical cerclage before curettage. Fertil Steril 2009; 91: 935. [DOI:10.1016/j.fertnstert.2008.11.009] [PMID]
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