Critical Appraisal OF Cervical Pregnancy Management

Abstract

For a long time, it was rare to see a case of cervical pregnancy (CP) throughout the journey in the field of obstetrics. Recently, the circumstances showed dramatic changes and I think not uncommonly every one elsewhere in the field may face this problem to some extent and the CP term strikes his/her ears. This may be attributed to an actual increase in CP rate that go parallel to widespread application of Assisted Reproduction Techniques (ART) procedures all over the world on one hand and earlier diagnosis owing to liberal utilization and more familiarity with Transvaginal Sonography (TVS) on the other hand [1]. Totally, CP was reported to be one in nine thousand pregnancies while it represented about two percent of ART ectopic pregnancies [2]. The maternal impact of this calamity is markedly variable. It may pass unnoticed, causing a little harm or catastrophic with late discovery and presentation with a life-threatening hemorrhage. The exact etiology is still unexplained and the patient commonly presented by delayed menstruation with or without bleeding and infrequent pain. Diagnosis of a pure CP is based on TVS. Sonographic criteria’s specific to the case include empty uterine corpus while cervix is enlarged and barrel shaped, presence of gestational sac below the internal os, Color Doppler demonstrated a peritrophoblastic blood flow around the gestational sac and no sliding sign. Management is greatly different depending upon timing of diagnosis, case presentation, operator experience and available health facilities [1].