Treatment of heterotopic cervical and intrauterine pregnancy

Carlos A. Carreno, Mary King, Mark P. Johnson, Yuval Yaron, Michael P. Diamond, Dana Bush, Mark I. Evans

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Objective: To find a suitable technique to selectively terminate a cervically implanted embryo while maintaining viability of a concomitant intrauterine pregnancy. Methods: A 34-year-old patient achieved a twin pregnancy after 4 IVF attempts. Ultrasound revealed a viable intrauterine and cervical pregnancy. Given our experience with KCl injection for fetal reduction, we offered the patient an attempt to reduce the cervical pregnancy. Results: Best visualization in this case was obtained by transabdominal scanning. A 6-inch 20-gauge spinal needle was inserted transcervically and maneuvered into the thorax of the embryo. Fetal heart rate ceased even before KCl could be injected. Then 3 cm3 of saline were injected to provide better visualization of the cervical fetus, and to confirm absence of heart beat. The patient had minor vaginal bleeding for several days. The intrauterine pregnancy progressed uneventfully through 361/2 weeks with delivery of a healthy, 2700-gram new-born. Conclusion: Cervical pregnancy is usually considered a life-threatening event. Other factors such as concomitant intrauterine pregnancy and the patient's infertility history generally would be secondary concerns. In this case, we were able to selectively terminate the cervical pregnancy, while preserving the intrauterine one, allowing this couple to have a healthy newborn. Further cases will be necessary to appropriately define risk rates for such an approach. Copyright (C) 2000 S. Karger AG, Basel.

Original languageEnglish (US)
Pages (from-to)1-3
Number of pages3
JournalFetal Diagnosis and Therapy
Volume15
Issue number1
DOIs
StatePublished - Jan 1 2000
Externally publishedYes

    Fingerprint

Keywords

  • Cervical pregnancy
  • Fetal reduction
  • Heterotopic pregnancy
  • Selective termination

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Embryology
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynecology

Cite this

Carreno, C. A., King, M., Johnson, M. P., Yaron, Y., Diamond, M. P., Bush, D., & Evans, M. I. (2000). Treatment of heterotopic cervical and intrauterine pregnancy. Fetal Diagnosis and Therapy, 15(1), 1-3. https://doi.org/10.1159/000020967