Abstract
Introduction:
Cervical pregnancy (CP) is a rare form of ectopic pregnancy (EP) that occurs in the cervical canal. Diagnosis and treatment are particularly challenging when the lesion is large and presents without typical symptoms. We report a case of a 16+-week CP patient with placenta accreta.
Case Presentation:
A 39-year-old woman presented with amenorrhea for four months but no associated symptoms. Doppler ultrasound revealed an enlarged uterus and a mixed echogenic mass in the lower uterine segment extending to the cervix, accompanied by rich blood flow signals. His serum β-HCG concentration was 576.68 mIU/ml. Following multidisciplinary evaluation, exploratory laparotomy under general anesthesia revealed a significantly enlarged cervix with prominent vascular networks. The patient underwent total abdominal hysterectomy with bilateral salpingectomy, with an intraoperative blood loss of 600 ml. Pathological examination confirmed the presence of placental villi in the cervix, consistent with CP. Postoperative recovery was uneventful, with serum β-HCG levels normalizing within a week, and no abnormalities were detected in follow-up assessments over six months.
Conclusion
This case underscores the diagnostic and therapeutic complexities associated with CP, especially when patients present with large lesions and atypical symptoms. Comprehensive clinical history, imaging findings, and serum HCG levels are crucial for accurate diagnosis and effective clinical decision-making. The successful management of this case highlights the importance of a multidisciplinary approach in addressing such rare and challenging conditions.