Surgery for Cervical Ectopic Pregnancy

Bassel H. Al Wattar, Yousri Afifi
In: Gynecologic and Obstetric Surgery · 2016 · pp. 256–258 · doi:10.1002/9781118298565.ch85 · W2491113398
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Abstract

This chapter discusses the background and the management of cervical ectopic pregnancy using a case history of a woman who was 8 weeks pregnant as an example. Cervical ectopic pregnancy is rare, with estimates ranging between 1 in 95,000 and 1 in 1000 pregnancies. Predisposing factors include an intrauterine contraceptive device (lUCD), Asherman's syndrome, previous uterine surgery such as endometrial curettage and cesarean section, in vitro fertilization, pelvic inflammatory disease, and endometriosis. Methotrexate is now considered the first line of management for cervical ectopic pregnancy in early gestation with no fetal heart activity. Laparotomy and hysterectomy, or interventional radiology, should be considered for a patient at risk of torrential hemorrhage. Dilatation and curettage (D&C) is the simplest form of surgical treatment, but when practiced alone can precipitate excessive bleeding. The chapter describes the use of operative hysteroscopy to resect the gestation sac under direct vision.

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endometriosis

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