Évora Francisco, Hundarova Kristina, Águas Fernanda, Carvalho Giselda
Obstetrics and Gynecology, Coimbra Hospital and University Center, Coimbra, PRT.
Cureus. 2021 Oct 29;13(10):e19113. doi: 10.7759/cureus.19113. eCollection 2021 Oct.
Cervical ectopic pregnancy is a rare but life-threatening condition in which early diagnosis and treatment are key to a successful outcome. In the past, this diagnosis led inevitably to a hysterectomy due to the risk of massive bleeding. Currently, the most effective method of treatment is yet to be found. We report a case of a 31-year-old nulliparous female with six weeks of amenorrhea and vaginal bleeding. The first approach missed the diagnosis, but an ultrasound performed by an expert revealed a gestational sac with an embryo in the cervical canal. The fertility-sparing therapeutic strategy involved performing treatment with systemic and local methotrexate, followed by embolization of the uterine artery and cervical curettage to remove the trophoblast. Our aim is to strengthen the importance of an early diagnosis and multidisciplinary perspective. Uterine artery embolization was the key to minimizing bleeding, enabling a treatment that preserved fertility.
宫颈异位妊娠是一种罕见但危及生命的疾病,早期诊断和治疗是成功治疗的关键。过去,由于存在大出血风险,这种诊断不可避免地导致子宫切除术。目前,尚未找到最有效的治疗方法。我们报告一例31岁未生育女性,停经6周并有阴道出血。首次检查漏诊,但专家进行的超声检查发现宫颈管内有一个带有胚胎的妊娠囊。保留生育功能的治疗策略包括全身和局部使用甲氨蝶呤,随后进行子宫动脉栓塞和宫颈刮宫以清除滋养层。我们的目的是强化早期诊断和多学科视角的重要性。子宫动脉栓塞是减少出血的关键,从而实现了保留生育功能的治疗。