Definition - What does Cervical Pregnancy mean?
Cervical pregnancy is a rare type of ectopic pregnancy in which the fertilized egg or embryo implants itself outside of its normal location in the uterus at the cervical canal. Cervix is the narrow lowest portion of the uterus and the thin internal passage of the cervix is the cervical canal. Cervical pregnancy affects 1 in 1,000 to 1 in 18,000 pregnancies. In a cervical pregnancy, the embryo will not be able to survive because of the failure to acquire the nutrients it needs and not having sufficient room for its growth.
FertilitySmarts explains Cervical Pregnancy
Factors that enhance the risk for a cervical pregnancy include prior dilatation and curettage (D&C), prior cesarean sections (c-section), use of intrauterine devices (IUD), and in vitro fertilization (IVF).
A cervical pregnancy starts like a normal pregnancy with the absence of menses; however, vaginal bleeding is apparent as soon the pregnancy miscarries.
When a woman presents with symptoms suggestive of cervical pregnancy, the doctor performs a physical examination. The presence of the following signs on examination is indicative of a cervical pregnancy:
- A bigger cervix equal to or even larger than the upper portion of the uterus (called fundus)
- Products of pregnancy (including the fetus and placenta) are attached to the cervix
- The external opening of the cervix, called the cervical os is partially opened.
A cervical pregnancy usually miscarries within the first trimester, except for certain types. Sometimes, the embryo implants near the bottom narrowest portion of the uterus called isthmus. This type of cervical pregnancy is more common than a true cervical pregnancy and is more likely to progress to an advanced stage in pregnancy, probably up to the second or even third trimester. However, this type is also not free of complications and can be life-threatening due to the risk of massive bleeding resulting from erosion of the blood vessels coursing the cervix.
An ultrasound of the pelvis shows a uterus that is empty and the presence of the products of conception are near or in the cervix.
When an ultrasound confirms the presence of a cervical pregnancy that has not aborted spontaneously, the doctor terminates the non-viable pregnancy by dilatation and curettage (D&C). Massive uterine bleeding can, however, complicate a D&C. Doctors control this bleeding by procedures like electrocautery (destruction of the products of conception via electric current), balloon tamponade, medications, and/or by uterine artery embolization. Balloon tamponade is a procedure in which a thin, sterile tube containing a deflated balloon is passed through the cervix into the uterus. The balloon is then inflated to fill the uterus and the cervical canal with enough pressure, which stops the bleeding.
Massive bleeding may require a hysterectomy to control bleeding, which takes a heavy toll on a woman's reproductive potential.
As with any other ectopic pregnancy, healthcare professionals advise waiting for at least three months or two complete menstrual cycles following a cervical pregnancy before trying to get pregnant again.