Castillo-Luna R, Zea-Prado F, Torres-Valdez E

Language: Spanish
References: 20
Page: 648-655
PDF size: 0. Kb.

ABSTRACT

Cervical ectopic pregnancy is a rare and danger clinical presentation because it has high risk of massive bleeding. The incidence is reported in 1:2,500 pregnancies and has high relation with a history of cervical dilatation and curettage and assisted reproductive techniques. Advances in ultrasound resolution and use of β fraction of human chorionic gonadotropin allow early diagnosis and provide conservative treatment with decreased morbidity, mortality and fertility preservation. Various techniques have been reported associated with cervical curettage, to reduce bleeding at the implantation site. In this report three cases of cervical ectopic pregnancy managed with cervical curettage, prior vaginal impingement of uterine arteries (Zea Technique) at the Instituto Nacional de Perinatología Isidro Espinosa de los Reyes are described. The Zea technique represents an effective option in the control of obstetric hemorrhage, including patients diagnosed with cervical ectopic pregnancy in who the bleeding volume decrease after its placement. The Zea Technique is easy to apply and preserves fertility. The success of combining this technique with endocervical curettage for the management of cervical ectopic pregnancy is demonstrated. Training for performing this technique does not require highly specialized or highly complex resources since the required material is the usual every area of obstetric care.

REFERENCES

1. Oron G, Tulandi T. A pragmatic and evidence-based management of ectopic pregnancy. J Minim Invasive Gynecol 2013;220:446-454.

2. Sharma A, Ojha R, Mondal S, Chattapadhyay S. Segupta P. Cervical intramural pregnancy: report of a rare case. Niger Med J 2013;54:271-273.

3. Tsai S, Huang K, Ou Y, Hsu T, Wang C, Chang M, et al. Lowlying- implantation ectopic pregnancy: a cluster of cesarean scar, cervico-isthmus, and cervical ectopic pregnancies in the fist trimester. Taiwan J Obstet Gyne 2013;52:505-511.

4. Weibel H, Alserri A, Reinhold C, Tulandi T. Multidoses methotrexate treatment of cervical pregnancy. J Obstet Gynaecol Can 2012;34:359-362.

5. Kameswari S. A case of cervical ectopic pregnancy: successful therapy with methotrexate. J Obstet Gynaecol India 2012;62:S1-S3.

6. Kochi K, Hidaka T, Yasoshima K, Yoneda K, Arai K, Arai T. Cervical pregnancy: a report of four cases. J Obstet Gynaecol Res 2014; 40:603-606.

7. Scutiero G, Nappi L, Matteo M, Balzano S, Macarini L, Greco P. Cervical pregnancy trated by uterine artery embolization combined with office hysteroscopy. Eur J Obst Gynecol Reprod Biol 2013;166:104-106.

8. Ahmadi F, Irani S. Cervical ectopic pregnancy following assisted reproductive technology: a case report. Int J Fertil Steril 2012;6:201-204.

9. Tayade S, Tembhare A, Kamala N. Conservative management of cervical pregnancy: A case report. Pravara Med Rev 2012;4:24-26.

10. Havaldar N, Naik K, Gowda L. A rare case of cervical ectopic pregnancy treated successfully with single-dose methotrexate. Saudi J Health Sci 2012;1:156-158.

11. Rio de la Loza L, Moyers J. Embarazo ectópico cervical. Cuando el tratamiento conservador falla. Reporte de un caso y revisión de la bibliografía. Ginecol Obstet Mex 2012;80:668-672.

12. Gurel S. Ectopic pregnancy. Ultrasound Clin 2008;3:331-43.

13. Laifer S, Tabori N. Ultrasound for obstetric emergencies. Ultrasound Clin 2011;6:177-193.

14. The diagnosis and management of ectopic pregnancy. Clinical practice guideline. Instituto of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland and Directorate of Clinical Strategy and Programmes, Health Service Executive, 2014.

15. Molina A, Calvo O, Amoroso M, Reyes R. Falla del tratamiento conservador con metotrexato en un embarazo ectópico cervical. Ginecol Obstet Mex 2012;80:348:354.

16. Vizcaíno C, Trujillo J, Grover F. Embarazo cervical. Comuniación de un caso y revisión de la literatura. Ginecol Obstet Mex 2006;74:594-598.

17. Awoleke J. Cervical pregnancy: diagnosis and management options. Trop J Obstet Gynaecol 2012;29:88-95.

18. Kofinas J, Purisch S, Brandt J, Montes M. Hysteroscopic removal of cervical ectopic pregnancy following fialed intramuscular/intra-sac methotrexate: a case report. J Gynecol Surg 2012;28:369-371.

19. Kamar S, Rathod S. Cervical ectopic pregnancy. J Nat Sc Biol Med 2015;6:257:260.

20. Zea F, Espino S, Morales F. Pinzamiento vaginal de arterias uterinas en hemorragia puerperal: Técnica Zea para control de hemorragia obstétrica. Perinatol Reprod Human 2011;25:54-56.