Document Detail


Treatment of heterotopic cervical and intrauterine pregnancy.
MedLine Citation:
PMID:  10705207     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 cm(3) 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 36(1)/(2) weeks with delivery of a healthy, 2, 700-gram newborn. 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.
Authors:
C A Carreno; M King; M P Johnson; Y Yaron; M P Diamond; D Bush; M I Evans
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Fetal diagnosis and therapy     Volume:  15     ISSN:  1015-3837     ISO Abbreviation:  Fetal. Diagn. Ther.     Publication Date:    2000 Jan-Feb
Date Detail:
Created Date:  2000-04-13     Completed Date:  2000-04-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9107463     Medline TA:  Fetal Diagn Ther     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  1-3     Citation Subset:  IM    
Copyright Information:
Copyright 2000 S. Karger AG, Basel.
Affiliation:
Department of Obstetrics, Wayne State University, Detroit, Mich., USA.
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MeSH Terms
Descriptor/Qualifier:
Abortion, Therapeutic* / adverse effects,  methods
Adult
Cervix Uteri
Female
Fertilization in Vitro
Humans
Potassium Chloride / administration & dosage
Pregnancy
Pregnancy, Ectopic / surgery*,  ultrasonography
Risk Factors
Ultrasonography, Prenatal
Uterine Hemorrhage / etiology
Chemical
Reg. No./Substance:
7447-40-7/Potassium Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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