Experience of a Tertiary Service in the Treatment of Women with Cervical Pregnancy

Abstract Objective Cervical pregnancy is challenging for the medical community, as it is potentially fatal. The treatment can be medical or surgical; however, there are no protocols that establish the best option for each case. The objective of the present study was to describe the cases of cervical pregnancy admitted to a tertiary university hospital over a period of 18 years. Methods A retrospective study based on a review of the medical records of all cervical pregnancies admitted to the Women's Hospital at Universidade Estadual de Campinas, Southeastern Brazil, from 2000 to 2018. Results We identified 13 cases of cervical pregnancy out of a total of 673 ectopic pregnancies; only 1 case was initially treated with surgery because of hemodynamic instability. Of the 12 cases treated conservatively, 7 were treated with single-dose intramuscular methotrexate, 1, with intravenous and intramuscular methotrexate, 1, with intravenous methotrexate, 1, with 2 doses of intramuscular methotrexate, and 2, with intra-amniotic methotrexate. Of these cases, one had a therapeutic failure that required a hysterectomy. Two women received blood transfusions. Four women required cervical tamponade with a Foley catheter balloon for hemostasis. There was no fatal outcome. Conclusion Cervical pregnancy is a rare and challenging condition from diagnosis to treatment. Conservative treatment was the primary method of therapy used, with satisfactory results. In cases of increased bleeding, cervical curettage was the initial treatment, and it was associated with the use of a cervical balloon for hemostasis.

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Main Authors: Mori,Karen Hiromi, Tavares,Bárbara Virgínia, Yela,Daniela Angerame, Baccaro,Luis Francisco Cintra, Juliato,Cassia Raquel Teatin
Format: Digital revista
Language:English
Published: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia 2022
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032022001101014
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spelling oai:scielo:S0100-720320220011010142023-01-20Experience of a Tertiary Service in the Treatment of Women with Cervical PregnancyMori,Karen HiromiTavares,Bárbara VirgíniaYela,Daniela AngerameBaccaro,Luis Francisco CintraJuliato,Cassia Raquel Teatin cervical pregnancy ectopic pregnancy methotrexate surgery treatment Abstract Objective Cervical pregnancy is challenging for the medical community, as it is potentially fatal. The treatment can be medical or surgical; however, there are no protocols that establish the best option for each case. The objective of the present study was to describe the cases of cervical pregnancy admitted to a tertiary university hospital over a period of 18 years. Methods A retrospective study based on a review of the medical records of all cervical pregnancies admitted to the Women's Hospital at Universidade Estadual de Campinas, Southeastern Brazil, from 2000 to 2018. Results We identified 13 cases of cervical pregnancy out of a total of 673 ectopic pregnancies; only 1 case was initially treated with surgery because of hemodynamic instability. Of the 12 cases treated conservatively, 7 were treated with single-dose intramuscular methotrexate, 1, with intravenous and intramuscular methotrexate, 1, with intravenous methotrexate, 1, with 2 doses of intramuscular methotrexate, and 2, with intra-amniotic methotrexate. Of these cases, one had a therapeutic failure that required a hysterectomy. Two women received blood transfusions. Four women required cervical tamponade with a Foley catheter balloon for hemostasis. There was no fatal outcome. Conclusion Cervical pregnancy is a rare and challenging condition from diagnosis to treatment. Conservative treatment was the primary method of therapy used, with satisfactory results. In cases of increased bleeding, cervical curettage was the initial treatment, and it was associated with the use of a cervical balloon for hemostasis.info:eu-repo/semantics/openAccessFederação Brasileira das Sociedades de Ginecologia e ObstetríciaRevista Brasileira de Ginecologia e Obstetrícia v.44 n.11 20222022-11-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032022001101014en10.1055/s-0042-1757954
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libraryname SciELO
language English
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author Mori,Karen Hiromi
Tavares,Bárbara Virgínia
Yela,Daniela Angerame
Baccaro,Luis Francisco Cintra
Juliato,Cassia Raquel Teatin
spellingShingle Mori,Karen Hiromi
Tavares,Bárbara Virgínia
Yela,Daniela Angerame
Baccaro,Luis Francisco Cintra
Juliato,Cassia Raquel Teatin
Experience of a Tertiary Service in the Treatment of Women with Cervical Pregnancy
author_facet Mori,Karen Hiromi
Tavares,Bárbara Virgínia
Yela,Daniela Angerame
Baccaro,Luis Francisco Cintra
Juliato,Cassia Raquel Teatin
author_sort Mori,Karen Hiromi
title Experience of a Tertiary Service in the Treatment of Women with Cervical Pregnancy
title_short Experience of a Tertiary Service in the Treatment of Women with Cervical Pregnancy
title_full Experience of a Tertiary Service in the Treatment of Women with Cervical Pregnancy
title_fullStr Experience of a Tertiary Service in the Treatment of Women with Cervical Pregnancy
title_full_unstemmed Experience of a Tertiary Service in the Treatment of Women with Cervical Pregnancy
title_sort experience of a tertiary service in the treatment of women with cervical pregnancy
description Abstract Objective Cervical pregnancy is challenging for the medical community, as it is potentially fatal. The treatment can be medical or surgical; however, there are no protocols that establish the best option for each case. The objective of the present study was to describe the cases of cervical pregnancy admitted to a tertiary university hospital over a period of 18 years. Methods A retrospective study based on a review of the medical records of all cervical pregnancies admitted to the Women's Hospital at Universidade Estadual de Campinas, Southeastern Brazil, from 2000 to 2018. Results We identified 13 cases of cervical pregnancy out of a total of 673 ectopic pregnancies; only 1 case was initially treated with surgery because of hemodynamic instability. Of the 12 cases treated conservatively, 7 were treated with single-dose intramuscular methotrexate, 1, with intravenous and intramuscular methotrexate, 1, with intravenous methotrexate, 1, with 2 doses of intramuscular methotrexate, and 2, with intra-amniotic methotrexate. Of these cases, one had a therapeutic failure that required a hysterectomy. Two women received blood transfusions. Four women required cervical tamponade with a Foley catheter balloon for hemostasis. There was no fatal outcome. Conclusion Cervical pregnancy is a rare and challenging condition from diagnosis to treatment. Conservative treatment was the primary method of therapy used, with satisfactory results. In cases of increased bleeding, cervical curettage was the initial treatment, and it was associated with the use of a cervical balloon for hemostasis.
publisher Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
publishDate 2022
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032022001101014
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