Use of ultrasound and magnetic resonance imaging in the diagnosis of cervical pregnancy

✍ Scribed by Birgit Bader-Armstrong; Yogesh Shah; Deborah Rubens

• Publisher: John Wiley and Sons
• Year: 1989
• Tongue: English
• Weight: 347 KB
• Volume: 17
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.1870170410

✦ Synopsis

Cervical pregnancy is a rare occurrence that may become a life-threatening situation. A cervical abortion has clinical and sonographic findings similar to a cervical pregnancy, and an accurate diagnosis is critical when making management decisions. This case demonstrates the sonographic criteria for a cervical pregnancy. Magnetic resonance images complimented not only the ultrasound findings, but also confirmed the suspicion that implantation had occurred at the site of a previous cesarean section scar.

CASE REPORT

A 29-year-old white female, gravida 3, para 2, with uncertain dating was referred to confirm a suspected diagnosis of cervical pregnancy made at another institution. The pregnancy was complicated by a three-week history of vaginal spotting and pelvic pain. The patient had undergone two previous low transverse cesarean sections. Pelvic examination revealed an anteverted uterus with a bulky, tender, barrel-shaped cervix. The external 0s was closed, and there were no palpable adnexal masses.

Real-time ultrasound examination demonstrated an anteverted uterus with prominent endometrial echoes in the fundus, consistent with either decidual reaction or blood (Figure 1). A gestational sac containing a 1.37-cm fetus compatible with a menstrual age of 7.5 weeks was located in the region of the endocervical canal.