Successful Management of Cervical Ectopic Pregnancy with Multimodal Intervention: A Case Report

Arega BN*, Hailu DM, Essa AA, Terefe WG and Mekonnin AW

Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, Bahir Dar University, Ethiopia

^*Correspondance to: Bantayehu Nega Arega 

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Abstract:

Cervical ectopic pregnancy is a rare obstetric complication that can result in significant risk of lifethreatening hemorrhage, necessitating prompt diagnosis and treatment. It accounts for less than one percent of all extra-uterine pregnancies; it poses unique challenges due to the absence of established management guidelines. Despite its rarity, the incidence of cervical ectopic pregnancies is increasing due to in vitro fertilization and increasing in cesarean delivery. A high index of suspicion, along with clinical and radiological correlation, particularly in cases with previous uterine scars, can aid in preoperative detection. We present the case of a 35-year-old para II both cesarean delivery mother, who presented with minimal, bright red, and painless vaginal bleeding at 7+3 weeks’ gestation from the reliable last normal menstrual period. With an initial serum beta HCG level of 79,918 mIU/ml and positive fetal cardiac activity, a multimodal intervention strategy was employed, including multiple-dose systemic methotrexate, local potassium chloride injection, and cervical dilation and curettage. This approach successfully treated the cervical ectopic pregnancy while preserving the patient's fertility. Our case underscores the importance of early diagnosis and multimodal management in optimizing outcomes for cervical ectopic pregnancies. To preserve fertility in the management of cervical ectopic pregnancy with high serum β-HCG, clinicians could consider a combination of strategies.

Keywords:

Cervical ectopic pregnancy; Methotrexate; Fertility preserving treatment; Potassium chloride injection; Dilation and curettage

Cite the Article:

Arega BN, Hailu DM, Essa AA, Terefe WG, Mekonnin AW. Successful Management of Cervical Ectopic Pregnancy with Multimodal Intervention: A Case Report. Ann Clin Case Rep. 2024; 9: 2616..