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ISSN 1561-3062 (Electronic)

2015, Number 2

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Revista Cubana de Obstetricia y Ginecología 2015; 41 (2)

Behavior of Cervical Pregnancy at 'Ramón González Coro' Gynecobstetric Teaching Hospital

Tamayo LTG, Couret CMP, García SI

Language: Spanish
References: 46
Page:
PDF size: 234.64 Kb.


ABSTRACT

Introduction: Cervical pregnancy represents less than 1% of ectopic pregnancies. It is an exceptional phenomenon that occurs in 1 out of 2500 - 18 000 pregnancies. The morbidity and mortality from this cause are high, but they can be reduced with early diagnosis.
Objectives: Describe the incidence of cervical ectopic pregnancy in patients admitted to "Ramón González Coro" Gynecobstetric Teaching Hospital and relate some variables, such as risk factors, symptoms and treatment used.
Method: A descriptive, retrospective and cross-sectional study was performed in four patients admitted to Ramón González Coro Gynecobstetric Teaching Hospital from January 2006 to December 2012. The difference between proportions of selected qualitative variables was used between the modes of treatment and the difference between means of quantitative variables.
Results: The incidence of cervical pregnancy was close to 1% of ectopic. Ages ranged from 31-41 years, and 75% were nulliparous. Two patients (50%) reported pain, menstrual delay bleeding. Radical surgery was performed in a multiparous patient with 11 weeks of gestation.
Conclusions: The incidence of cervical pregnancy has remained similar to that reported in the literature. The history of ectopic pregnancy was not significant. Most patients were nulliparous and ages in which this condition presented were over 30 years. The prevailing symptoms were pain, bleeding and menstrual delay. There was a significant trend towards the use of drug therapy.


REFERENCES

  1. Yáñez R, Martínez P, Ibáñez Y, Benavides B, Vega CA. Embarazo ectópico ístmico-cervical en cicatriz de cesárea previa. Rev. Chil. Obstet. Ginecol. 2007; 72(3): 186-89.

  2. Fernández C. El embarazo ectópico se incrementa en el mundo. Rev. Cubana Obstet. Ginecol. [revista en la Internet]. 2011 Mar [citado 2013 Oct 25]; 37(1): 84-99. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-600X2011000100010&lng=es .

  3. United Nations. UN Millennium Development Goals Disponible en: http://www.un.org/millenniumgoals/. Accessed June 25, 2008.

  4. World Health Organization (WHO). The WorldHealth Report 2005: Make every Mother and Child Count. Geneva, Switzerland: WHO;2005. Disponible en: http://www.who.int/whr/2005/whr2005_en.pdf. Accessed June 25, 2008.

  5. Adanu R. The challenge of meeting the Millennium Development Goal for maternal health. Int J Gynecol Obstet. 2008; 102:1-2.

  6. Aguilar M, Vázquez Y, Areces G, de la Fuente M, Tamayo T. Diagnóstico y manejo conservador del embarazo ectópico cervical. Rev. Cubana Obstet. Ginecol. [revista en la Internet]. 2012 Mar [citado 2013 Oct 25]; 38(1): 80-85. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-600X2012000100009&lng=es.

  7. Molina Sosa A, Calvo Aguilar O. Falla del tratamiento conservador con methotrexate en un embarazo ectópico cervical. Ginecol. Obstet. México 2012; 80(5):348-54.

  8. Capote R, Carrillo L, Guzmán R, Varona J, Mohamed M. Embarazo ectópico cervical: Presentación de un caso. Rev. Cubana Obstet. Ginecol. [revista en la Internet]. 2007 Abr [citado 2013 Oct 24]; 33(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-600X2007000100002&lng=es.

  9. Cifuentes J. Embarazo cervical: una decisión difícil de tomar. Rev. Chil. Ultrasonografía 2006; 9 (1): 10-12.

  10. Jaeger C, Hauser N, Gallinat R, Kreienberg R, Sauer G, Terinde R. Cervical ectopicpregnancy: surgicalor medical treatment? Gynecological Surgery. 2007; 4(2) 117-21.

  11. Briceño Pérez C. Embarazo cervical. Rev. Obstet. Ginecol. Venezuela. 2002; 62 (4): 13-9.

  12. Martín A, Garrido B, García L, Benítez L, Maañón J. Tratamiento del embarazo ectópico cervical con metotrexato y rescate con leucovorina. Progresos de Obstetricia y Ginecología. 2011; 54(7):379-82.

  13. Kirk E, Condous G, Haider Z, Syed A, Ojha K, Bourne T. The conservative management of cervical ectopic pregnancies. Ultrasound Obstet. Gynecol. 2006; 27:430-37.

  14. Api O, Unal O, Api M, Ergin M, Alkan N, Kars B, et al. Ultrasonography appearance of cervical pregnancy following successful treatment with methotrexate. Ultrasound obstetgynecol [revista en la Internet].2006 [citado 2013 Oct 28]; 28(6):845-47. Disponible en http://onlinelibrary.wiley.com/doi/10.1002/uog.3846/full

  15. MukulLv, Teal Sb. Current management of ectopic pregnancy. Obstet. Gynecol. Clin. N Am [revista en la Internet]. 2007[citado 2013 Oct 24]; 34(3):403-19. Disponible en: http://www.sciencedirect.com/science/article/pii/S0889854507000629

  16. Ushakov, elchalal u, acemanpj, schenkerjg. Cervical pregnancy: past and future. Obstetgynecolsurv. 1997; 52:45.

  17. Kung FT, Lin H, Hsu TY. Differential diagnosis of suspected cervical pregnancy and conservative treatment with the combination of laparoscopy-assisted uterine artery ligation and hysteroscopic endocervical resection. Fertil Steril. 2004; 81:1642-9.

  18. Spitzer D, Steiner H,Graf A, Zajc M, Staudach A. Conservative treatment of cervical pregnancy by curettage and local prostaglandin injection. Hum. Reprod. [revista en la Internet].1997 [citado 2013 Oct 25]; 12 (4): 860-66. Disponible en: http://humrep.oxfordjournals.org/content/12/4/860.short

  19. Oyer R, Tarakjian D, Lev-Toaff A, Friedman A, Chatwani A. Treatment of cervical pregnancy with methotrexate. Obstetrics & Gynecology. [revista en la Internet]. 1998 [citado 2013 Oct 25]; (71):3.Disponible en: http://journals.lww.com/greenjournal/Abstract/1988/03001/Treatment_of_Cervical_Pregnancy_With_Methotrexate.14.aspx

  20. Lorente A, Pallarés M, Pérez S, Campos M, Maldonado V, Torres J. Metotrexato sistémico o intrasacular en el tratamiento del embarazo cervical. Progresos de Obstetricia y Ginecología . [revista en la Internet] 2011 [citado 2013 Oct 24]; 54(6): 306-9. Disponible en: http://linkinghub.elsevier.com/retrieve/pii/S0304501311001154?via=sd

  21. Martínez N, Guzmán M, González J, Martínez E, Solano J, Nieto A, Heron S, Zapico A. Tratamiento médico de la gestación ectópica cervical: Nuevos avances. Progresos de Obstetricia y Ginecología. [revista en la Internet] 2012 [citado 2013 Oct 24]; 55 (4): 204-8. Disponible en: http://linkinghub.elsevier.com/retrieve/pii/S0304501311004651?via=sd

  22. Marrugo-Flórez M, Valencia M, Hernández-Ramírez E. Embarazo ectópico en cicatriz de cesárea: Presentación de un caso. Revista Científica Salud Uninorte. [revista en la Internet] 2013[citado 2013 Oct 24]; (29):3. Disponible en: http://rcientificas.uninorte.edu.co/index.php/salud/article/viewArticle/5521

  23. Scott J, Diggory P, Edelman P. Management of cervical pregnancy with circumsuture and intracervical obturator. Br Med J 1978; 1: 825-6.

  24. Troncoso F, Cardone X, Rondini C. Embarazo ectópico cervical. Diagnóstico y tratamiento conservador con cerclaje cervical. Rev. Chil. Obstet. Ginecol. 2005; 70(4): 257-60.

  25. Mashiach S, Admon D, Zalel Y. et al. Cervical Shirodkar cerclage may be treatment modality of choice for cervical pregnancy. Hum Reprod 2002; 17(2): 493-6.

  26. Nelson RM. Bilateral internal iliac artery ligation in cervical pregnancy: conservation of reproductive function. American Journal of Obstetrics and Gynecology. 1979; 134(2):145-50.

  27. Ratten GJ. Cervical pregnancy treated by ligation of the descending branch of the uterine arteries: Case report. Br J Obstet Gynaecol 1983; 90: 367-71.

  28. Simon P, Donner C, Delcour C et al. Selective uterine artery embolization in the treatment of cervical pregnancy: Two cases. Eur J Obstet Gynecol Reprod Biol 1991; 40: 159-61.

  29. Elías JA. Embarazo ectópico cervical. Tratamiento con methotrexate en monodosis y resección histeroscópica. Publicado: 11/06/2009 | Ginecología y Obstetricia. Imágenes de ginecología y obstetricia. casos. Argentina. Disponible en: http://portalesmedicos.com

  30. Wang Y, Xu B, Dai S, Zhang Y, Duan Y, Sun C. An efficient conservative treatment modality for cervical pregnancy: angiographic uterine artery embolization followed by immediate curettage. Am J Obstet Gynecol [revista en la Internet].2011; [citado 2013 Oct 28]; 204(31):1-7. Disponible en: http://www.sciencedirect.com/science/article/pii/S0002937810011038

  31. Mohammad R. Mohebbi, Kurt A. Rosenkrans, Eric E. Luebbert, Tauhni T. Hunt, and Michael J. Jung, “Ectopic Pregnancy in the Cervix: A Case Report,” Case Reports in Medicine. 2011 Article ID 858241, 2 pages, 2011. doi:10.1155/2011/858241. Disponible en: http://www.hindawi.com/journals/crim/2011/858241/cta/

  32. Taylor J, Yalcinkaya T, Akar M. Successful conservative management of cervical ectopic pregnancy: a case series. Arch Gynecol Obstet. 2011; 283(6): 1215-17.

  33. Kochi K, Hidaka T, Yasoshima K, Yoneda K, Arai K, Arai T. Cervical pregnancy: A report of four cases. Journal of Obstetrics and Gynaecology Research. 2014; 40 (2): 603-6.

  34. Solís H, Ramos P, Jefferson L. Embarazo ectópico cervical tratado con methotrexate. Sociedad Peruana Ginecol. & obstet 1997 [citado 2013 Oct 28]; 43(2). Disponible en: http://sisbib.unmsm.edu.pe/BVRevistas/ginecologia/Vol_43N2/indexg.htm

  35. Tejero EL, Ortega S, Royo B, Andrés P, Lapresta M, Campillos JM. Gestación ectópica cervical tratada mediante punción ecoguiada intrasacular de metotrexato. Rev. Chil. Obstet. Ginecol. [revista en la Internet]. 2010 [citado 2014 Mayo 29]; 75(5): 325-328. Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-75262010000500009&lng=es . http://dx.doi.org/10.4067/S0717-75262010000500009.

  36. Asante A, Verma U Coddington CC, Stewart EA. Single-dose intramuscular methotrexate treatment of cervical ectopic pregnancy. A case report. J Reprod Med. [revista en la Internet]. 2015 Jan-Feb [citado 2014 Oct 25]; 60(1-2):78-82. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/25745757 http://www.ncbi.nlm.nih.gov/pubmed/25745757

  37. Moya Toneut C, Pino Pérez FV, Borges Fernández R, Aguiar Delgado R, Olano Trujillo Y, Espinosa Fuentes ML. Comportamiento del embarazo ectópico. Rev. Cubana Obstet. Ginecol. [revista en la Internet]. 2013 Sep [citado 2014 Jun 03]; 39(3): 236-248. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-600X2013000300003&lng=es.

  38. Altunaga Palacio M, Rodríguez Morales Y, Lugones Botell M. Manejo del embarazo ectópico. Rev Cubana Obstet Ginecol [revista en la Internet]. 2011 Dic [citado 2014 Jun 03]; 37(4): 513-523. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-600X2011000400008&lng=es.

  39. Rodríguez Morales Y, Altunaga Palacio M. Factores epidemiológicos en el embarazo ectópico. Rev. Cubana Obstet. Ginecol. [revista en la Internet]. 2010 Mar [citado 2014 Jun 03]; 36(1): 36-43. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-600X2010000100006&lng=es.

  40. Petousis S Margioula-Siarkou C, Kalogiannidis I, Karavas G Palapelas V Prapas N Rousso D. Conservative management of cervical pregnancy with intramuscular administration of methotrexate and KCl injection: Case report and review of the literature. World J Clin Cases. [revista en la Internet]. 2015 [citado 2014 Oct 25]; 3(1):81-4. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295223/

  41. Singh S. Diagnosis and management of cervical ectopic pregnancy. J Hum Reprod Sci. [revista en la Internet]. 2013 [citado 2015 Mar 11]; 6(4): 273–76. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3963313/

  42. Álvarez Zapata D, Minaberriet Conceiro E, Puertas Álvarez D, Govín Puerto O. Caracterización de las pacientes con Embarazo Ectópico en el Hospital Materno 10 de Octubre. Año 2011. Rev. Cubana de Tecnología de la Salud [Internet]. 2013 [citado 10 jul 2013]; 4(1). Disponible en: http://www.revtecnologia.sld.cu/index.php/tec/article/view/93/137

  43. Sharma A Ojha R Mondal S Chattopadhyay S Sengupta P Cervical intramural pregnancy: Report of a rare case. Niger Med J. [revista en la Internet]. 2013 [citado 2015 Mar 11]; 54(4):271-3. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821232/

  44. Surampudi K. A Case of Cervical Ectopic Pregnancy: Successful Therapy with Methotrexate. J Obstet Gynaecol India. [revista en la Internet]. 2012 [citado 2015 Mar 11]; Dec; 62(Suppl 1): 1–3. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3632676/

  45. Bretón P, Garcés M, Orós D, González-de-Agüero R, Romero MA, Fabre E. Tratamiento conservador de la gestación ectópica cervical. Ginecol Obstet Mex [revista en la Internet] 2012 [citado 2015 Mar 11];80(8):514-20.Disponible en: http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=23088070&lang=es&site=ehost-live

  46. Martínez R, Pérez M, Torriente B. Embarazo ectópico cervical tratado con metotrexate: Reporte de un caso. Rev Cubana Obstet. Ginecol. [revista en la Internet] 2000 Ago [citado 2013 Oct 28]; 26(2): 87-90. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-600X2000000200004&lng=es.




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