ABSTRACT
A 24 year old Nigerian woman with cervical pregnancy, a very rare type of ectopic pregnancy, is presented. The disorder can be life-threatening and usually there is difficulty in differentiating it from the cervical phase of an incomplete abortion as well as bleeding cervical fibroid. Ultrasound scan has been found helpful in the diagnosis of cervical ectopic pregnancy. The conservative management and the possible alternative surgical management, based on the clinical presentation, are discussed.
PIP: Cervical pregnancy is a very rare, potentially life-threatening type of ectopic pregnancy. The condition is usually difficult to differentiate from the cervical phase of an incomplete abortion or a bleeding cervical fibroid. A 24-year-old Nigerian woman was seen in a private hospital with a history of 2.5 months amenorrhea, followed by irregular, occasionally heavy, vaginal bleeding for 8 days. She denied any history of associated abdominal pain or urinary symptoms. Before this recent period of morbidity, the woman's menses had been regular every 30 days with normal blood loss of 4 days' duration. She had had two prior normal deliveries, most recently 2 years earlier, and had no history of prior abortion, dilatation, and curettage; infertility; or any contraceptive practice before consultation. Vaginal examination found no active bleeding, but a bulky, soft, 1-2 cm dilated cervix. An ultrasound scan obtained by the patient in another private clinic one day earlier identified an empty uterine cavity, but a bulky cervix with a gestational sac and fetal node. The patient was to be admitted for immediate evacuation, but left the hospital in search of money for the operation. The products of conception were evacuated at the hospital the next day. The patient was in satisfactory condition with no complaints at 4 weeks follow-up.
