Background: Cervical pregnancy is one of the rarest ectopic pregnancies, and it is often diagnosed as intrauterine pregnancy if careful examination is not undertaken. Termination of pregnancy can be hazardous, leading to hemorrhage when diagnosis is missed. Case: A 25-year-old woman, gravida 2, with a previous history of lower-segment cesarean delivery (LSCD) underwent medical termination of pregnancy (MTP) at 2 months of pregnancy, by pharmaceutical methods followed by dilatation and curettage. She did not undergo ultrasound examination prior to the procedure. She had continuous bleeding from her vagina for 25 days, and a transvaginal examination at the Jawaharlal Institute of Postgraduate Medical Education and Research showed an irregular gestational sac in the cervix below the internal os. Her β–human chorionic gonadotropin (β-hCG) was 146.2 (mIU)/mL, and she was treated with a variable dose of methotrexate. Results: This patient responded well to one course of methotrexate and her β-hCG normalized in 20 days. Conclusions: The diagnosis and confirmation of cervical pregnancy can be made easily with transvaginal ultrasound examination. The response using mifepristone and misoprostol to achieve MTP is not good, most probably because of implantation into the endocervical glands and stroma. Methotrexate is a better option for managing cervical ectopic pregnancy. Transvaginal ultrasonography is essential/mandatory before subjecting the patient to MTP. (J GYNECOL SURG 30:373)
KobayashiM, HillmanLM, FillistLP. Ultrasound, an aid in the diagnosis of ectopic pregnancy. Am J Obstet Gynecol, 1969; 103:1131.
3.
WangWS, HsuCH, LuoJS, YinCS. Ultrasonographic diagnosis of cervical pregnancy: 2 case reports. J Med Sci, 1990; 11:55.
4.
PaalmanRJ, McElinTW. Cervical pregnancy. Am J Obstet Gynecol, 1959; 77:1261.
5.
VelaG, TulandiT. Cervical pregnancy: The importance of early diagnosis and treatment. J Minim invasive Gynecol, 2007; 14:481.
6.
PostawskiK, RomanekK, WróbelA, RechbergerT. Conservative treatment of cervical pregnancy in women: A review of literature with case report. Ginekol Pol, 2009; 80:704.
SongMJ, MoonMH, KimJA, KimTJ. Serial transvaginal sonographic findings of cervical ectopic pregnancy treated with high dose methotrexate. J Ultrasound Med, 2009; 28:55.
9.
FerraraL, BelogolovkinV, GandhiM, LittonC, JacobsA, SaltzmanD, RebarberA. Successful management of a consecutive cervical pregnancy by sonographically guided transvaginal local injection: Case report and review of literature. J Ultrasound Med, 2007; 26:959.
10.
TakanoM, HasegawaY, MatsudaH, KikuchiY. Successful management of cervical pregnancy by selective uterine artery embolisation: A case report. Reprod Med, 2004; 49:986.
11.
NakaoY, YokoyamaM, IwasakaT. Uterine artery embolisation followed by dilatation and curettage for cervical pregnancy. Obstet Gynecol, 2008; 111:505.
12.
DavisLB, LathiRB, MilkiAA, DahanMH. Transvaginal ligation of cervical branches of uterine artery and injection of vasopression in a cervical pregnancy as an initial step to controlling haemorrhage: A case report. J Reprod Med, 2008:53:365.
13.
ManginoFP, CeccarelloM, Di LorenzoG, D'OttavioG, BogattiP, RicciG. Successful rescue hysteroscopic resection of cervical ectopic pregnancy previously treated with methotrexate with no combined safety precautions. Clin Exp Obstet Gynecol, 2014; 41:214.
14.
TuncerR, UygurD, KisS, KayinS, BebitogluI, ErkayaS. Inevitable hysterectomy despite conservative surgical management in advanced cervical pregnancy: A case report. J Obstet Gynecol Reprod Biol., 2001; 100:102.
