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Successful Management of Live Cervical Ectopic Pregnancy: A Case Report

机译:宫颈活体异位妊娠的成功管理:一例报告

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摘要

Cervical pregnancy is a rare form of ectopic pregnancy with potential grave consequences occurring in approximately 1:9,000 deliveries. It is life-threatening as the pregnancy is implanted in the endocervical canal and the trophoblast can penetrate through the cervical wall and into the uterine blood supply resulting in catastrophic haemorrhage. Historically, the treatment had been hysterectomy because of the considerable risk of life-threatening haemorrhage, but in the recent past various conservative management modalities have been applied to preserve fertility. Here, we report a case of successful (both medical and surgical) management of cervical ectopic pregnancy in a young woman. A 29-year-old, gravid 2, para1 and living 1 with previous caesarean section had presented with mild bleeding per vagina for 5 days following 7 weeks of amenorrhoea. Past menstrual, medical, surgical and family history were unremarkable except the previous caesarean section. On examination vital signs were normal but pelvic examination revealed a distended cervix with bulky uterus, without anyadnexal mass or tenderness and no cervical motion tenderness. Further transvaginal sonography showed a live cervical gestation of 7 weeks and 4 days and serum beta-HCG value of 1,03,113mIU/ml. Patient received conservative approach with combination of intraamniotic potassium chloride and methotrexate and suction curettage. Due to conservative approach emergency hysterectomy and blood transfusion was avoided.
机译:子宫颈妊娠是异位妊娠的一种罕见形式,可能在大约1:9,000分娩时发生严重后果。由于将妊娠植入宫颈管内,滋养细胞可以穿透宫颈壁并进入子宫血液供应,从而危及生命,从而危及生命。从历史上看,由于有相当大的危及生命的出血风险,该治疗方法一直是子宫切除术,但是在最近的过去,已经采用了各种保守的管理方式来保持生育能力。在这里,我们报道了一名年轻女子成功(医疗和外科)宫颈异位妊娠治疗的案例。一名经过剖腹产的29岁妊娠胎儿2 para1和live 1在闭经7周后的5天内出现了每个阴道轻度出血。除前一次剖腹产外,过去的月经,内科,外科和家族史均不明显。检查时生命体征正常,但骨盆检查显示宫颈扩张,子宫膨大,无任何肾上腺肿块或压痛,无颈项运动压痛。进一步的经阴道超声检查显示宫颈活妊娠7周零4天,血清β-HCG值为1,03,113mIU / ml。患者采用保守的方法,结合使用羊膜内氯化钾和氨甲蝶呤并进行刮宫术。由于采用保守的方法,避免了紧急子宫切除术和输血。

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