What Is a Cervical Pregnancy?

Fertilized egg implantation and development in the cervical canal is called cervical pregnancy, which is extremely rare, and the incidence is about 1/18000. In recent years, with the large number of assisted reproductive technologies, the incidence of cervical pregnancy has increased. More common in menstrual women, menopause and early pregnancy reactions, because the fertilized eggs implanted in the cervical part of the fibrous tissue, so pregnancy is rarely maintained until 20 weeks.

Basic Information

English name

Cervical Pregnancy

Visiting department

Obstetrics and Gynecology

Multiple groups

Maternity

Common locations

Cervix

Common causes

Fertilized eggs run too fast, uterine dysplasia, uterine malformations, uterine fibroids, endocrine disorders, assisted reproduction techniques, etc., and cervical damage

Common symptoms

Painless vaginal bleeding or bloody secretions, bleeding from small to large, or intermittent vaginal bleeding

Causes of cervical pregnancy

1. Fertilized eggs run too fast, and they have entered the cervical canal before they have the ability to grow.

2. Uterine dysplasia, uterine malformations, uterine fibroids, endocrine disorders, and assisted reproduction techniques may also be relevant factors.

3. Cervical injury caused by various reasons.

Clinical manifestations of cervical pregnancy

The main symptoms are painless vaginal bleeding or bloody secretions. The amount of bleeding is generally from small to large, and it can also be intermittent massive vaginal bleeding.

Cervical pregnancy test

Peripheral blood

Routine examination of a small amount of bleeding can be normal, a large amount of bleeding can be positive cells, positive pigment anemia, normal platelets, normal or increased white blood cell count.

2. Pregnancy test

The pregnancy test results were positive.

3. Gynecological examination

Examination revealed that the cervix was significantly enlarged and barrel-shaped, softened and turned blue, the rim of the cervix had a thin margin of expansion, the inner mouth was tightly closed, and the uterine body was normal in size and hardness or slightly larger and softer.

4. Detection of blood -hCG (-human chorionic gonadotropin)

Increased blood -hCG.

5.B-ultrasound

(1) Dilation of the cervical canal;

(2) There is a complete pregnancy sac in the cervical canal, and sometimes germ or fetal heart can be seen;

(3) The internal cervix is closed;

(4) The uterine cavity is empty.

Color Doppler ultrasound is used to investigate the infiltration of the trophoblast into the cervical interstitium and the location of the uterine arteries. The uterine artery crosses the ureter to the lateral edge of the uterus at a level of 2 cm from the inner mouth of the cervix. This anatomical location can help determine whether the pregnancy site is below the histological cervix of the cervix to help diagnose cervical pregnancy.

Cervical pregnancy diagnosis

Diagnostic criteria for cervical pregnancy:

1. Gynecological examination found a normal-sized uterus above the enlarged cervix.

2. The pregnancy product is completely inside the cervical canal.

3. Segmented curettage, no pregnancy products were found in the uterine cavity.

Cervical pregnancy treatment

After diagnosis, cervical canal curettage or cervical canal curettage can be performed. Preoperative blood transfusion preparation or uterine artery embolization should be prepared to reduce intraoperative bleeding; gauze strips can be used to fill the cervical canal wound or apply small The sac is compressed to stop bleeding. If the bleeding does not stop, bilateral internal iliac artery ligation can be performed. If the effect is not good, timely hysterectomy should be performed to save lives.

In order to reduce bleeding during curettage and avoid uterine removal, in recent years MTX (immunomodulatory) treatment has been used before surgery. After MTX treatment, the embryo died, the surrounding villous tissue was necrotic, and the amount of bleeding was significantly reduced during curettage.