Classification and management of cervical ectopic pregnancies

Experience at a single institution

Jong Ha Hwang, Jae Kwan Lee, Min Jeong Oh, Nak Woo Lee, Jun Young Hur, Kyu Wan Lee

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

OBJECTIVE: To classify cervical ectopic pregnancies including previous cesarean section scar pregnancies and to describe the management of cervical ectopic pregnancies. STUDY DESIGN: This was a retrospective analysis of all cervical ectopic pregnancies, including previous cesarean scar pregnancies, diagnosed at the Korea University Guro Hospital, Seoul, Korea, between January 1997 and October 2009 using transvaginal ultrasound. Clinical and demographic data were recorded in all cases. The pregnancies were categorized into three groups and subclassified into five types on the basis of transvaginal ultrasound and history of a previous cesarean delivery. The management of cervical pregnancies included medical treatment such as systemic methotrexate (single dose or multiple doses) or intraamniotic methotrexate and surgical treatment such as dilation and curettage (D&C), laparoscopic exploration and hysterectomy. RESULTS: Forty cervical ectopic pregnancies including previous cesarean section scar pregnancies were diagnosed. Cesarean section scar-related pregnancy (intramural type and nonintramural type) and cesarean section scar-unrelated pregnancy accounted for 10, 12 and 18 cases, respectively. D&C was performed in 21 patients and was successful in all cases except one. The success rate of medical treatment was 61.5% (8/13). Nine patients (22.5%) required a blood transfusion, and a total hysterectomy was performed in five patients (12.5%). CONCLUSION: Cervical ectopic pregnancies were classified, including previous cesarean scar pregnancies, into five types based on the findings of transvaginal ultrasound and history of a previous cesarean delivery.

Original languageEnglish
Pages (from-to)469-476
Number of pages8
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume55
Issue number11-12
Publication statusPublished - 2010 Nov 1

Fingerprint

Ectopic Pregnancy
Cicatrix
Pregnancy
Cesarean Section
Korea
Hysterectomy
Methotrexate
Dilatation and Curettage
Curettage
Blood Transfusion
Dilatation
Therapeutics
Demography

Keywords

  • Cesarean section
  • Cesarean section scar pregnancies
  • Classification
  • Ectopic
  • Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine

Cite this

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title = "Classification and management of cervical ectopic pregnancies: Experience at a single institution",
abstract = "OBJECTIVE: To classify cervical ectopic pregnancies including previous cesarean section scar pregnancies and to describe the management of cervical ectopic pregnancies. STUDY DESIGN: This was a retrospective analysis of all cervical ectopic pregnancies, including previous cesarean scar pregnancies, diagnosed at the Korea University Guro Hospital, Seoul, Korea, between January 1997 and October 2009 using transvaginal ultrasound. Clinical and demographic data were recorded in all cases. The pregnancies were categorized into three groups and subclassified into five types on the basis of transvaginal ultrasound and history of a previous cesarean delivery. The management of cervical pregnancies included medical treatment such as systemic methotrexate (single dose or multiple doses) or intraamniotic methotrexate and surgical treatment such as dilation and curettage (D&C), laparoscopic exploration and hysterectomy. RESULTS: Forty cervical ectopic pregnancies including previous cesarean section scar pregnancies were diagnosed. Cesarean section scar-related pregnancy (intramural type and nonintramural type) and cesarean section scar-unrelated pregnancy accounted for 10, 12 and 18 cases, respectively. D&C was performed in 21 patients and was successful in all cases except one. The success rate of medical treatment was 61.5{\%} (8/13). Nine patients (22.5{\%}) required a blood transfusion, and a total hysterectomy was performed in five patients (12.5{\%}). CONCLUSION: Cervical ectopic pregnancies were classified, including previous cesarean scar pregnancies, into five types based on the findings of transvaginal ultrasound and history of a previous cesarean delivery.",
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AU - Lee, Nak Woo

AU - Hur, Jun Young

AU - Lee, Kyu Wan

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N2 - OBJECTIVE: To classify cervical ectopic pregnancies including previous cesarean section scar pregnancies and to describe the management of cervical ectopic pregnancies. STUDY DESIGN: This was a retrospective analysis of all cervical ectopic pregnancies, including previous cesarean scar pregnancies, diagnosed at the Korea University Guro Hospital, Seoul, Korea, between January 1997 and October 2009 using transvaginal ultrasound. Clinical and demographic data were recorded in all cases. The pregnancies were categorized into three groups and subclassified into five types on the basis of transvaginal ultrasound and history of a previous cesarean delivery. The management of cervical pregnancies included medical treatment such as systemic methotrexate (single dose or multiple doses) or intraamniotic methotrexate and surgical treatment such as dilation and curettage (D&C), laparoscopic exploration and hysterectomy. RESULTS: Forty cervical ectopic pregnancies including previous cesarean section scar pregnancies were diagnosed. Cesarean section scar-related pregnancy (intramural type and nonintramural type) and cesarean section scar-unrelated pregnancy accounted for 10, 12 and 18 cases, respectively. D&C was performed in 21 patients and was successful in all cases except one. The success rate of medical treatment was 61.5% (8/13). Nine patients (22.5%) required a blood transfusion, and a total hysterectomy was performed in five patients (12.5%). CONCLUSION: Cervical ectopic pregnancies were classified, including previous cesarean scar pregnancies, into five types based on the findings of transvaginal ultrasound and history of a previous cesarean delivery.

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