Organ-preserving treatment in progressive cervical pregnancy. A clinical case
- Authors: Sulima A.N.1,2, Gunar Z.V.2, Adamov A.M.1, Gordeychik A.E.3, Mkrtchian A.A.3, Davydova A.A.1, Tkacheva N.Y.1
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Affiliations:
- V.I. Vernadsky Crimean Federal University
- Simferopol City Clinical Maternity Hospital No. 1
- N.A. Semashko Republican Clinical Hospital
- Issue: Vol 72, No 2 (2023)
- Pages: 113-120
- Section: Theory and Practice
- URL: https://journals.rcsi.science/jowd/article/view/131204
- DOI: https://doi.org/10.17816/JOWD320930
- ID: 131204
Cite item
Abstract
This article describes a rare clinical case of progressive ectopic pregnancy in the cervix in a female patient of reproductive age, the incidence of which is less than 1% of all ectopic pregnancies. The exact etiopathogenetic mechanism of cervical pregnancy is still unknown. Misdiagnosis of cervical pregnancy can lead to a fatal outcome with massive bleeding and is associated with the risk of hysterectomy and complete loss of fertility in patients of reproductive age.
This article presents the results of a pathoanatomical study confirming the diagnosis and adequacy of the performed therapeutic measures. We demonstrated the complexity of diagnosing this pathology, as well as the possibility and conditions for performing an organ-preserving surgery. The presented clinical case will allow doctors of various specialties to know more about this rare form of ectopic pregnancy, to suspect and successfully diagnose cervical pregnancy in the early stages of gestation, which will avoid or reduce the development of severe and sometimes life-threatening complications.
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##article.viewOnOriginalSite##About the authors
Anna N. Sulima
V.I. Vernadsky Crimean Federal University; Simferopol City Clinical Maternity Hospital No. 1
Email: gsulima@yandex.ru
ORCID iD: 0000-0002-2671-6985
SPIN-code: 2232-0458
Scopus Author ID: 57214970506
ResearcherId: P-3191-2015
MD, Dr. Sci. (Med.), Professor
Russian Federation, Simferopol; SimferopolZoya V. Gunar
Simferopol City Clinical Maternity Hospital No. 1
Email: gunar_z@mail.ru
ORCID iD: 0000-0002-8885-2130
Russian Federation, Simferopol
Alexandr M. Adamov
V.I. Vernadsky Crimean Federal University
Email: adamovalexandr.2021@gmail.com
ORCID iD: 0000-0003-3312-0319
SPIN-code: 2181-8876
Scopus Author ID: 57957491400
Russian Federation, Simferopol
Andrey E. Gordeychik
N.A. Semashko Republican Clinical Hospital
Email: androng1818@mail.ru
Russian Federation, Simferopol
Azat A. Mkrtchian
N.A. Semashko Republican Clinical Hospital
Email: mkrtchyan@list.ru
ORCID iD: 0000-0002-6568-5632
SPIN-code: 5721-0534
Russian Federation, Simferopol
Aleksandra A. Davydova
V.I. Vernadsky Crimean Federal University
Email: akzag@mail.ru
ORCID iD: 0000-0003-0843-1465
SPIN-code: 9796-9984
MD, Cand. Sci. (Med.), Assistant Professor
Russian Federation, SimferopolNataly Yu. Tkacheva
V.I. Vernadsky Crimean Federal University
Author for correspondence.
Email: na1tka@rambler.ru
ORCID iD: 0000-0001-8212-8566
SPIN-code: 6369-4948
MD, Cand. Sci. (Med.), Assistant Professor
Russian Federation, SimferopolReferences
- Anikin SS, Sulima AN, Zabolotnov VA, et al. Osobennosti khirurgicheskogo lecheniya zhenshchin s vnematochnoi beremennost’yu i ego vliyanie na reproduktivnuyu funktsiyu. In: Besplodnyi brak. Vspomogatel’nye reproduktivnye tekhnologii: mezhregional’naya nauchno-prakticheskaya konferentsiya; may 14-16. Rostov-on-Don; 2017. (In Russ.)
- Tanos V, ElAkhras S, Kaya B. Hysteroscopic management of cervical pregnancy: case series and review of the literature. J Gynecol Obstet Hum Reprod. 2019;48(4):247–253. doi: 10.1016/j.jogoh.2018.05.001
- Alalade AO, Smith FJE, Kendall CE, Odejinmi F. Evidence-based management of non-tubal ectopic pregnancies. J Obstet Gynaecol. 2017;37(8):982–991. doi: 10.1080/01443615.2017.1323852
- Gomel V. From laparotomy to laparoscopy to in vitro fertilization. Fertil Steril. 2019;112(2):183–196. doi: 10.1016/j.fertnstert.2019.06.028
- Rybalka AN, Sulima AN, Rumyantseva ZS, et al. Ectopic pregnancy. Simferopol; 2021. (In Russ.)
- Fetishcheva LE, Ushakova GA, Petrich LN. Ectopic pregnancy: risk factors, a problems of diagnosis, treatment, the restoration of fertility. Mother and Baby in Kuzbass. 2017;1(68):16–24. (In Russ.)
- Di Tizio L, Spina MR, Gustapane S, et al. Interstitial pregnancy: from medical to surgical approach-report of three cases. Case Rep Obstet Gynecol. 2018;2018. doi: 10.1155/2018/2815871
- Dolinko AV, Vrees RA, Frishman GN. Non-tubal ectopic pregnancies: overview and treatment via local injection. J Minim Invasive Gynecol. 2018;25(2):287–296. doi: 10.1016/j.jmig.2017.07.008
- Stabile G, Romano F, Buonomo F, et al. Conservative treatment of interstitial ectopic pregnancy with the combination of mifepristone and methotrexate: our experience and review of the literature. Biomed Res Int. 2020;2020. doi: 10.1155/2020/ 8703496
- Giampaolino P, de Rosa N, Morra I, et al. Management of cesarean scar pregnancy: a single-institution retrospective review. Biomed Res Int. 2018;2018. doi: 10.1155/2018/6486407
- Mutiso SK, Oindi FM, Hacking N, et al. Uterine necrosis after uterine artery embolization for symptomatic fibroids. Case Rep Obstet Gynecol. 2018;2018. doi: 10.1155/2018/9621741
- Stabile G, Mangino FP, Romano F, et al. Ectopic pregnancy on the cervix: a method of treatment. Medicine (Kaunas). 2020;56(6):293. doi: 10.3390/medicina56060293
- Jurkovic D, Hacket E, Campbell S. Diagnosis and treatment of early cervical pregnancy: a review and a report of two cases treated conservatively. Ultrasound Obstet Gynecol. 1996;8(6):373–380. doi: 10.1046/j.1469-0705.1997.08060373.x
- Nemat AbdulRahman AbdulJabbar, Saquib S, Mohammed Talha WE. Successful management of abdominal pregnancy: two case reports. Oman Med J. 2018;33(2):171–175. doi: 10.5001/omj.2018.32
- Elmokadem AH, Abdel-Wahab RM, El-Zayadi AA, et al. Uterine artery embolization and methotrexate infusion as sole management for caesarean scar and cervical ectopic pregnancies: a single-center experience and literature review. Can Assoc Radiol J. 2019;70(3):307–316. doi: 10.1016/j.carj.2018.12.002
- Mangino FP, Romano F, Di Lorenzo G, et al. Total hysteroscopic treatment of cervical pregnancy: the 2-step technique. J Minim Invasive Gynecol. 2019;26(6):1011–1012. doi: 10.1016/j.jmig.2019.01.009
- Long Y, Zhu H, Hu Y, et al. Interventions for non-tubal ectopic pregnancy. Cochrane Database Syst Rev. 2020;7(7). doi: 10.1002/14651858.CD011174.pub2