Rare abnormal pregnancy implantation: A case report of 39 year old G2P1 with cervical ectopic gestation

The case is that of a 39 year old G2P 1, 1 alive who presented with recurrent bleeding per vagina following 8weeks amenorrhea, Pregnancy confirmed with urine test. She was married and no attempts at termination of pregnancy. Ultrasound scan revealed empty uterus without any adnexea mass but a gestational sac in the cervical canal with an active fetus and vascular flow on Doppler colour interrogation. A diagnosis of cervical ectopic pregnancy was made and she had medical management with initial mifepristone and then intramuscular methotrexate. A subsequent gentle evacuation of the cervical canal was done and trans-cervical catheter inserted for 2 weeks to prevent cervical adhesion. Urine Pregnancy test done after 3 weeks was negative.

Conclusion: Cervical ectopic pregnancy is one of the very rare forms of pregnancy implantation that can be associated with devastating outcome but prompt diagnosis and management help improve patient’s prognosis.