Non-radical surgical treatment of cervical pregnancy after IVF/ET: a case report

Česká verzia

Authors: MUDr. Renáta Krajčovičová; prim. MUDr. Robert Hudeček, Ph.D.
Authors place of work: Gynekologicko-porodnická klinika LF MU a FN Brno
Published in the journal: Prakt Gyn 2008; 12(1): 28-32

Summary

Introduction:
Cervical pregnancy is rare type of ectopic pregnacy, which is characteristed by implantation of gestational sac in cervix. Incidence move between 1 : 2500–1 : 18 000. The most severe complication of cervical pregnancy is massive even a life threatening haemorrhage from placenta accreta ending often with hysterctomy. Ultrasonographic visualization of gestational sac with fetal cardiac action or evidence of endocervical trofoblastic invasion by color Doppler visualisation of peritrofoblastic flows have absolutely priority in diagnostic of cervical pregnancy. Correlation with increasing serum levels of hCG is allways very important. We can use surgical intervence or conservative medicamentous treatment in the therapy of cervical pregnanacy. Objektive − presenting of high effective, patient unweighting nonradical surgical treatment of cervical pregnancy using casuistic and providing a self-contained overview of the above issue.

Material and methods:
Reference cervical pregnancy casuistic following IVF/ET, diagnostic algorithm and surgical treatment.

Conclusion:
There is not available therapeutic guideline with regard to oneness of incidence. Alternative of medicamentous or surgical therapy have to be under discussion individually in each case. Our surgical operation – revisio canalis cervicis uteri et cavi uteri separata was performed under ultrasonographic control with ligation rami cervicalis arteriae uterinae and aplication of uterotonics. The risk of hysterectomy is minimal by lege artis performing of operation. Possibility of spontal pregnancy or repetition of IVF/ET are staying well-preserved.

Key words:
cervical pregancy – ectopic pregnancy – extrauterine pregnnancy – methotrexate – metrorrhage – cervical abortion

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