A Rare Case of Cervical Ectopic Pregnancy and Successful Management

Abstract Cervical ectopic pregnancy (CEP), an uncommon variant of ectopic pregnancy, accounts for <1% of all ectopic pregnancies. However, because of the potential for fatal bleeding caused by the erosion of cervical blood arteries, it is associated with considerable risks of maternal morbidity and mortality. Cervical pregnancies have increased as a result of the current surge in invasive procedures, artificial reproductive technologies, and cesarean sections. To comprehend the challenges involved in the diagnosis of cervical ectopic pregnancies and the necessity for early diagnosis for conservative management. A 35-year-old G4P2L2A1 with prior 1 lower segment cesarean section (LSCS), presented with 8-week amenorrhea with bleeding per vaginum for 5 days followed by spotting for 2 days before presentation. The patient was vitally stable. Blood investigation reports revealed moderate anemia, and serum beta human chorionic gonadotropin (HCG) value was 26,859 mIU/mL. An empty uterine cavity and a gestational sac in the anterior substance of the cervix, with the upper half of the sac extending into a scar from a prior LSCS, were observed on transvaginal ultrasonography. CEP has been diagnosed provisionally. Magnetic resonance imaging report revealed low-lying gestational sac along the previous C-section scar, with the possibility of cesarean scar pregnancy or cervical pregnancy. After correction of anemia, suction and gentle cervical curettage were done. Beta HCG level postprocedure was 6730 mIU/mL. The postoperative period was uneventful. The histopathology report has established the presence of chorionic villi and decidual tissue. The patient was discharged from the hospital on the third postoperative day, with orders to follow up with levels of beta-HCG, which confirmed full resolution. When women present with vaginal bleeding during early pregnancy, it is crucial to consider cervical pregnancy as a differential diagnosis even though it is very uncommon among ectopic pregnancies. An early identification allows for conservative care without severe consequences.