Cervical Pregnancy

Cervical pregnancy is a rare and potentially life-threatening condition where a fertilized egg implants in the cervix instead of the uterus. This type of ectopic pregnancy occurs when the embryo attaches to the cervical tissue, which is not designed to support a growing fetus.

Causes and Risk Factors

The exact cause of cervical pregnancy is often unknown, but several factors may increase the risk of developing this condition. These include:

• Prior uterine or cervical surgery, such as a cesarean section or cone biopsy
• In vitro fertilization (IVF) or other assisted reproductive technologies
• History of pelvic inflammatory disease (PID) or other infections
• Anatomical abnormalities of the uterus or cervix
• Use of an intrauterine device (IUD) for contraception

Symptoms

The symptoms of cervical pregnancy may be similar to those experienced during a normal pregnancy, but they can also include:

• Vaginal bleeding or spotting, which can be heavy and prolonged
• Pelvic pain or cramping
• Abdominal tenderness
• Nausea and vomiting
• Fatigue

Diagnosis

Cervical pregnancy is typically diagnosed using a combination of:

• Transvaginal ultrasound to visualize the embryo and its location
• Pelvic exam to assess the size and shape of the uterus and cervix
• Beta-hCG blood tests to measure hormone levels
• Imaging studies, such as MRI or CT scans, to confirm the diagnosis and rule out other conditions

Treatment

The primary goal of treatment for cervical pregnancy is to prevent complications and preserve fertility. Treatment options may include:

• Expectant management, where the patient is closely monitored for signs of complications
• Medical management with methotrexate or other medications to stop the growth of the embryo
• Surgical intervention, such as a dilation and curettage (D&C) procedure or a hysterectomy, in severe cases

Complications

Cervical pregnancy can lead to serious complications, including:

• Severe bleeding, which can be life-threatening
• Cervical rupture or perforation
• Infection or sepsis
• Fertility problems or infertility

Prevention

While it is not possible to completely prevent cervical pregnancy, women can reduce their risk by:

• Practicing safe sex and using contraception effectively
• Avoiding smoking and substance abuse
• Maintaining a healthy weight and lifestyle
• Seeking regular prenatal care if they become pregnant

Frequently Asked Questions (FAQs)

What is cervical pregnancy?
A rare type of ectopic pregnancy where the embryo implants in the cervix.

How common is cervical pregnancy?
It is estimated to occur in about 1 in 1,000 to 1 in 16,000 pregnancies.

What are the symptoms of cervical pregnancy?
Symptoms may include vaginal bleeding, abdominal pain, and cervical motion tenderness.

Can cervical pregnancy be diagnosed with ultrasound?
Yes, transvaginal ultrasound is often used to diagnose cervical pregnancy.

Is cervical pregnancy viable?
Generally, cervical pregnancies are not viable due to the high risk of complications.

What are the risks associated with cervical pregnancy?
Risks include severe bleeding, cervical rupture, and infertility.

How is cervical pregnancy typically treated?
Treatment usually involves surgical or medical intervention to remove the embryo.

Can methotrexate be used to treat cervical pregnancy?
Methotrexate may be used in some cases, but its effectiveness and safety are not well established for this condition.

Is expectant management an option for cervical pregnancy?
Expectant management is generally not recommended due to the high risk of complications.

Can cervical pregnancy increase the risk of future infertility?
Yes, treatment for cervical pregnancy may increase the risk of future infertility or complications in subsequent pregnancies.