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 language | English (US) |
|---|---|
| Pages (from-to) | 1-3 |
| Number of pages | 3 |
| Journal | Fetal Diagnosis and Therapy |
| Volume | 15 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2000 |
| Externally published | Yes |
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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
Treatment of heterotopic cervical and intrauterine pregnancy. / Carreno, Carlos A.; King, Mary; Johnson, Mark P.; Yaron, Yuval; Diamond, Michael Peter; Bush, Dana; Evans, Mark I.
In: Fetal Diagnosis and Therapy, Vol. 15, No. 1, 01.01.2000, p. 1-3.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Treatment of heterotopic cervical and intrauterine pregnancy
AU - Carreno, Carlos A.
AU - King, Mary
AU - Johnson, Mark P.
AU - Yaron, Yuval
AU - Diamond, Michael Peter
AU - Bush, Dana
AU - Evans, Mark I.
PY - 2000/1/1
Y1 - 2000/1/1
N2 - 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.
AB - 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.
KW - Cervical pregnancy
KW - Fetal reduction
KW - Heterotopic pregnancy
KW - Selective termination
UR - http://www.scopus.com/inward/record.url?scp=0034107838&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034107838&partnerID=8YFLogxK
U2 - 10.1159/000020967
DO - 10.1159/000020967
M3 - Article
VL - 15
SP - 1
EP - 3
JO - Fetal Diagnosis and Therapy
JF - Fetal Diagnosis and Therapy
SN - 1015-3837
IS - 1
ER -