Cervical pregnancy: dilatation and curettage and successful control of severe haemorrhage with Foley catheter

Abstract

Cervical pregnancy is a rare form of ectopic pregnancy in which the fertilized ovum implants in the endocervical canal. Its clinical presentation mimics threatened abortion. We report a case of cervical pregnancy in a grand-multiparous woman still desirous of more children, which was initially wrongly diagnosed, but which diagnosis was confirmed at dilatation and curettage. The torrential haemorrhage that ensued was eventually arrested with a Foley catheter, thus preserving the uterus. Haemorrhagic shock was prevented using plasma expanders, as the patient had refused to consent to blood transfusion. Other methods used in the management of cervical pregnancy are acknowledged. Sonographers are encouraged to acquaint themselves with the ultrasound features of cervical pregnancy as a way of curtailing the error in diagnosis, while physicians are advised to learn this conservative surgical skill which has been found very handy during emergency, and especially in our environment.

Keywords: cervical pregnancy, dilatation and curettage, severe haemorrhage, Foley catheter

Tropical Journal of Obstetrics and Gynaecology Vol. 23(1) 2006: 80-82