[ Grossesse cervicale : A propos d’un cas ]
Volume 25, Issue 4, March 2019, Pages 1432–1436
Zakaria IDRI1, Moulay Abdellah BABAHABIB2, Khadija BENCHAKROUN3, Yousra ESSAADI4, Jaouad Kouach5, and Driss Moussaoui6
1 Service de gynécologie-obstétrique, Hôpital Militaire d’Instruction Mohammed V, Rabat, Morocco
2 Service de gynécologie-obstétrique, Hôpital Militaire d’Instruction Mohammed V, Rabat, Morocco
3 Service de gynécologie-obstétrique, Hôpital Militaire d’Instruction Mohammed V, Rabat, Morocco
4 Service de gynécologie-obstétrique, Hôpital Militaire d’Instruction Mohammed V, Rabat, Morocco
5 Faculté de Médecine et de Pharmacie, Université Mohamed V, Rabat, Morocco
6 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
Original language: French
Copyright © 2019 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cervical pregnancy is one of the few ectopic locations after abdominal pregnancy. It is characterized by the migration of the conceptus the cervical canal sometimes simulating an ongoing abortion. Her diagnosis should be suspected in any woman with risk factors who has suggestive clinical criteria. The ultrasonographic criteria that have been described for this diagnosis are: closed internal orifice of the cervix, peritrophoblastic vascular flow detected in infra-cervical. MRI can be helpful in confirming the diagnosis. The anatomopathological study comes to focus on the diagnosis in case of surgical treatment. The treatment of cervical pregnancy uses several local, systemic methods, endoscopic, and surgical. Until now, no standard treatment is available in the literature. The therapeutic indications are then variously appreciated in the literature, the medical treatment using the Methotrexate is currently the treatment of choice before 12 weeks of amenorrhea, with or without potassium chloride. As for surgical treatment is placed in second line after failure of methotrexate, however some experienced practitioners prefer hysteroscopic resection, and embolization of the uterine artery associated or not with medical treatment. The choice of the technique will depend on the evolution of the initial treatment.
Author Keywords: Ectopic pregnancy, cervical pregnancy, ultrasound, methotrexate.
Volume 25, Issue 4, March 2019, Pages 1432–1436
Zakaria IDRI1, Moulay Abdellah BABAHABIB2, Khadija BENCHAKROUN3, Yousra ESSAADI4, Jaouad Kouach5, and Driss Moussaoui6
1 Service de gynécologie-obstétrique, Hôpital Militaire d’Instruction Mohammed V, Rabat, Morocco
2 Service de gynécologie-obstétrique, Hôpital Militaire d’Instruction Mohammed V, Rabat, Morocco
3 Service de gynécologie-obstétrique, Hôpital Militaire d’Instruction Mohammed V, Rabat, Morocco
4 Service de gynécologie-obstétrique, Hôpital Militaire d’Instruction Mohammed V, Rabat, Morocco
5 Faculté de Médecine et de Pharmacie, Université Mohamed V, Rabat, Morocco
6 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
Original language: French
Copyright © 2019 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Cervical pregnancy is one of the few ectopic locations after abdominal pregnancy. It is characterized by the migration of the conceptus the cervical canal sometimes simulating an ongoing abortion. Her diagnosis should be suspected in any woman with risk factors who has suggestive clinical criteria. The ultrasonographic criteria that have been described for this diagnosis are: closed internal orifice of the cervix, peritrophoblastic vascular flow detected in infra-cervical. MRI can be helpful in confirming the diagnosis. The anatomopathological study comes to focus on the diagnosis in case of surgical treatment. The treatment of cervical pregnancy uses several local, systemic methods, endoscopic, and surgical. Until now, no standard treatment is available in the literature. The therapeutic indications are then variously appreciated in the literature, the medical treatment using the Methotrexate is currently the treatment of choice before 12 weeks of amenorrhea, with or without potassium chloride. As for surgical treatment is placed in second line after failure of methotrexate, however some experienced practitioners prefer hysteroscopic resection, and embolization of the uterine artery associated or not with medical treatment. The choice of the technique will depend on the evolution of the initial treatment.
Author Keywords: Ectopic pregnancy, cervical pregnancy, ultrasound, methotrexate.
Abstract: (french)
La grossesse cervicale est l'une des rares localisations ectopiques après la grossesse abdominale. Elle est caractérisée par la migration du produit de conception au niveau du canal cervical simulant parfois un avortement en cours. Son diagnostic doit être soupçonné chez toute femme ayant des facteurs de risque et qui présente des critères cliniques évocateurs. Les critères échographiques qui ont été décrits pour ce diagnostic sont : orifice interne du col utérin fermé, flux vasculaire péritrophoblastique détecté en infra-cervicale. L'IRM peut être utile pour confirmer le diagnostic. L'étude anatomopathologique vient mettre le point sur le diagnostic en cas de traitement chirurgical. Le traitement de la grossesse cervicale fait appel à plusieurs méthodes locales, systémiques, endoscopiques, et enfin chirurgicales, jusqu'a l'heure actuelle, aucun traitement standardise n'est disponible dans la littérature. Les indications thérapeutiques sont alors diversement appréciées dans la littérature, le traitement médical par méthotrexate constitue actuellement le traitement de choix avant 12 semaines d'aménorrhée, associe ou non au chlorure de potassium. Quant au traitement chirurgical est place en deuxième ligne après échec du méthotrexate, toutefois pour certains praticiens expérimentés privilégient la résection hystéroscopique, et l'embolisation de l'artère utérine associé ou non au traitement médical. Le choix de la technique dépendra de l'évolution du traitement initiale.
Author Keywords: Grossesse ectopique , grossesse cervicale , échographie , méthotrexate.
How to Cite this Article
Zakaria IDRI, Moulay Abdellah BABAHABIB, Khadija BENCHAKROUN, Yousra ESSAADI, Jaouad Kouach, and Driss Moussaoui, “Cervical pregnancy : Case report,” International Journal of Innovation and Applied Studies, vol. 25, no. 4, pp. 1432–1436, March 2019.
