Hysteroscopic Treatment of Cervical Pregnancy: A Scoping Review of the Literature

Giovanni Di Lorenzo; Giuseppe Mirenda; Serena Springer; Maria Teresa Mirandola; Francesco Paolo Mangino; Federico Romano; Giuseppe Ricci

doi:10.1016/j.jmig.2021.09.712

Hysteroscopic Treatment of Cervical Pregnancy: A Scoping Review of the Literature

J Minim Invasive Gynecol. 2022 Mar;29(3):345-354.e1. doi: 10.1016/j.jmig.2021.09.712. Epub 2021 Sep 29.

Authors

Giovanni Di Lorenzo¹, Giuseppe Mirenda², Serena Springer², Maria Teresa Mirandola², Francesco Paolo Mangino³, Federico Romano³, Giuseppe Ricci⁴

Affiliations

¹ Institute for Maternal and Child Health, IRCCS "Burlo Garofolo," Via dell'Istria (Drs. Lorenzo, Mangino, Romano, and Ricci). Electronic address: giovanni.dilorenzo@burlo.trieste.it.
² Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, (Drs. Mirenda, Springer, Mirandola, and Ricci), Italy.
³ Institute for Maternal and Child Health, IRCCS "Burlo Garofolo," Via dell'Istria (Drs. Lorenzo, Mangino, Romano, and Ricci).
⁴ Institute for Maternal and Child Health, IRCCS "Burlo Garofolo," Via dell'Istria (Drs. Lorenzo, Mangino, Romano, and Ricci); Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, (Drs. Mirenda, Springer, Mirandola, and Ricci), Italy.

PMID: 34600146
DOI: 10.1016/j.jmig.2021.09.712

Abstract

Objective: Many therapies have been proposed for cervical pregnancy (CP) treatment; however, there is no consensus on the best practice to adopt, mainly owing to the rarity of this condition and the lack of randomized controlled trials. Therefore, there are no clinical practice guidelines for the management of this patient set. We presented an English literature review about the hysteroscopic management of CP.

Data sources: The literature review was performed according to the Preferred Reporting Items for Scoping Reviews. The search strategy aimed at identifying cases from the first patients tracked down to those diagnosed in May of 2021. We searched in PubMed, Scopus, Google Scholar, and MEDLINE databases. Mesh terms used included "Cervical Pregnancy," "Hysteroscopy," "Ectopic pregnancy," and "Resectoscopy."

Method of study selection: Case reports of randomized controlled trials, prospective controlled studies, prospective cohort studies, retrospective studies, case series, and case reports were considered eligible. Review, Letters to the Editor, and abstracts accepted at conferences were ruled out.

Tabulation, integration, and results: We found a total of 3572 articles in all analyzed databases. A total of 2480 articles viewed were duplicated and therefore ruled out. After screening and excluding nonpertinent articles, 109 were assessed for eligibility, and 19 were included in the analysis. All articles were single case reports, small case series with no criteria selection, randomization, or study planning. We classified them as follows: cases treated with 10 mm resectoscope, with or without pretreatments of previous CP hysteroscopic approach, and cases resolved with 5 mm hysteroscopy, with or without pretreatments of previous CP hysteroscopic approach.

Conclusion: The hysteroscopic method represents a feasible and safe approach to the CP treatment, although there are still some aspects to be clarified, such as the pretreatment need and the instruments' type and sizes based on the beta-subunit of human chorionic gonadotropin, pregnancy age, and dimension.

Keywords: Cervical ectopic pregnancy; Hysteroscopy; Resectoscopy.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Female
Humans
Hysteroscopy / methods
Pregnancy
Pregnancy, Ectopic* / therapy
Prospective Studies
Retrospective Studies