2014 Volume 66 Issue 1 Pages 18-23
Cervical pregnancy is a rare form of ectopic pregnancy. Since there is rich blood flow around the cervical canal, cervical pregnancy may cause massive bleeding, necessitating total hysterectomy. Recently, preservation of fertility has become possible by early diagnosis, but fertility-preserving treatment for cervical pregnancy has not been established. In this report, we present a case in which bleeding cervical pregnancy accompanied by a fetal heartbeat was successfully treated with a conservative approach. The patient was a 32-year-old nulliparous and nulligravid woman who had received fertility treatment. She noted a small amount of bleeding five weeks and five days after her last menstruation, and consulted her previous obstetrician, who suspected cervical pregnancy. On the next day, the patient consulted our hospital due to continuous massive bleeding. Transvaginal ultrasonography showed a gestational sac (GS) with a fetal heartbeat in the cervical canal, and, together with MRI findings, a diagnosis of cervical pregnancy was made. Since the patient was positive for a fetal heartbeat, showed a high hCG level of 15000 mIU/ml, and wished for the preservation of fertility, we performed intra-arterial infusion chemotherapy using actinomycin-D withuterine artery embolization to control active bleeding. On the day two after treatment, bleeding was decreased and GS disappeared from the cervical canal. The patients discharged on the day 16 without sever adverse effects.The serum hCG level became negative without additional treatment, and themenstrual cycle was normalized. [Adv Obstet Gynecol, 66 (1) : 18-23, 2014 (H26.2)]
