2022, Number 02
Conservative management in a patient with cervical ectopic pregnancy
Espinosa-González MC, Álvarez-Domínguez RG
Full text
Language: Spanish
References: 6
Page: 187-190
PDF size: 214.64 Kb.
ABSTRACT
Background: The clinical manifestations of ectopic pregnancies are variable and may be related to congenital factors, the age of the patient, previous ectopic pregnancies, among others.Objective: To report the case of a cervical ectopic pregnancy that received successful conservative medical treatment.
Clinical case: A 32-year-old patient, nulliparous, who came to the clinic due to vaginal bleeding and pain in the hypogastrium, of three hours of evolution. Physical examination reported: blood pressure 80-40 mmHg, heart rate 100 beats per minute, respiratory rate 22 breaths per minute, Glasgow 15-15; generalized mucocutaneous pallor and cryodiaphoresis. The blood count reported: hemoglobin 7.3 mg/dL; hematocrit of 22.6; leukocytes: 15,000; neutrophils: 90%; platelets: 255,000; blood classification: AB+, positive pregnancy test, and transvaginal ultrasound with a diagnostic impression of a mass in the cervical region, compatible with cervical pregnancy vs uterine myomatosis. With the ultrasound suspicion of ectopic pregnancy, the determination of the beta subunit of human chorionic gonadotropin (β-hCG) was requested, titrating it at 18,273 mUl/mL, which required a transfusion of two units of blood products, due to the hemoglobin concentration , optimizing her figures at 9.6 mg/dL, with stable vital signs and decreased vaginal bleeding. The diagnosis of cervical ectopic pregnancy was established. Treatment with tranexamic acid was started. Hemoglobin was within reference limits. The patient had a satisfactory evolution, with decreased bleeding, so conservative treatment was maintained.
Conclusion: Conservative treatment is an effective protocol in the follow-up and control of patients with ectopic pregnancy, since it reduces the risk of mortality and hysterectomy, after establishing the timely diagnosis, with anamnesis, ultrasound and β-hCG concentrations for diagnostic suspicion.
REFERENCES