Conservative Management of a Second-Trimester Cervical Ectopic Pregnancy

Area of Science:

• Reproductive Medicine
• Gynecologic Surgery
• Maternal-Fetal Medicine

Background:

• Cervical ectopic pregnancy is a rare obstetric complication.
• Historically, treatment often involved hysterectomy, leading to loss of fertility.
• This case highlights the need for fertility-sparing management options.

Observation:

• A 33-year-old patient presented with a 13 weeks 3 days' gestation cervical ectopic pregnancy.
• The patient expressed a strong desire for future fertility.
• Diagnosis was confirmed, necessitating an intervention.

Findings:

• A multi-step conservative management strategy was employed.
• Procedures included uterine artery embolization, fetal intrathoracic potassium chloride injection, amniocentesis, and ultrasound-guided suction dilation and curettage.
• Intracervical vasopressin, gelatin-thrombin matrix, and cervical cerclage were utilized to control bleeding and support the cervix.

Implications:

• Advanced cervical ectopic pregnancy can be managed conservatively with a combination of interventional radiology and surgical techniques.
• This approach offers a viable alternative to hysterectomy, preserving reproductive potential.
• Successful conservative management can be achieved even in advanced gestations, improving patient outcomes and fertility preservation.