Cervical pregnancy: a case report of hysteroscopic resection and balloon compression combined with systematic methotrexate treatment

Taiwan J Obstet Gynecol. 2022 Nov;61(6):1061-1064. doi: 10.1016/j.tjog.2022.01.005.

Abstract

Objective: Cervical pregnancy is a rare type of ectopic pregnancy. When the pregnancy is terminated, it will sometimes lead to persistent bleeding. In some cases, hysterectomy is inevitable and the patient loses fertility. Therefore, early diagnosis and targeted management with systemic or local injection of methotrexate is the first-line treatment. Multiple interventions of cervical pregnancy were used to prevent massive hemorrhage, including dilatation and curettage, laparoscopic resection, hysteroscopic resection combined with uterine artery embolization, or uterine artery clip.

Case report: We report a case of cervical pregnancy with a high beta-hCG level accompanied by a visible fetal heartbeat that was successfully treated with hysteroscopic cervical tissue resection and balloon compression combined with systemic administration of methotrexate.

Conclusion: Efficacy and safety with preserved fertility were important issues in the management of cervical pregnancy. We provide a safe, simple and effective treatment of cervical pregnancy.

Keywords: Cervical pregnancy; TCR (transvaginal cervical resection); ectopic pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Abortifacient Agents, Nonsteroidal* / therapeutic use
  • Balloon Occlusion*
  • Female
  • Hemorrhage / therapy
  • Humans
  • Methotrexate / therapeutic use
  • Pregnancy
  • Pregnancy, Ectopic* / drug therapy
  • Pregnancy, Ectopic* / surgery
  • Uterine Artery Embolization*

Substances

  • Methotrexate
  • Abortifacient Agents, Nonsteroidal