J Clin Ultmsound 7:217-218, 1979
ECTOPIC CERVICAL PREGNANCY T.T.S. Chow, M.B.B.S., M.R.C.O.G., F.R.C.S.(C 1, and S. Lindahl, R.T.R., R.D.M.S.
A pregnancy can occur in one of several ectopic locations, and diagnosis of the unsuitable location should be made as early as possible before rupture occurs. The commonest site for ectopic implantaFrom the Salvation Army Grace Hospital, Vancouver, British Columbia, Canada. For reprints contact S. Lindahl, R.T.R., R.D.M.S., Salvation A m y Grace Hospital, 678 West 26th Avenue, Vancouver, B.C. V5Z 2E6, Canada. @ 1979 by John Wiley & Sons, Inc. 0091-2751/79/030217-02 $01.OO.
tion is the fallopian tube. Other possible sites are the ovary, the broad ligament, the abdomen, the cervic uteri, or the uterine cornua-rudimentary horn (1) (Fig. 1).
CASE REPORT
A 43-year-old woman, para 2, gravida 5, presented on May 3, 1978, with a 12-week history of amenorrhea, her last normal menstrual period
FIGURE 1. Possible locations of ectopic pregnancy: (1) ovary. (2) fimbria. (3) ampulla, (4) isthmus, ( 5 ) interstitial segment, (6) cornua (rudimentary horn), (7) cervix, ( 8 ) broad ligament, (9) abdomen.
FIGURE 2. A: Sagittal section showing the ectopic gestation lodged in the cervix. 8: bladder; V: vagina; Cx: cervix; Ut: corpus uteri; GS: gestational sac. 8: Transverse section through the cervix showing the gestational sac. B: bladder; Cx: cervix; GS: gestational sac.
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being February 4, 1978. On March 30 she exDerienced heavy vaginal bleeding that lasted ior 5 days and was followed by mucoid dark-red spotting until April 28, when the bleeding recurred and continued. A pregnancy test was ordered, and as the result was negative, an ultrasound examination was requested. A gray scale scan was performed, with films being taken in the longitudinal and transverse directions (Figs. 2A, 2B).The corpus uteri was slightly bulky and appeared to be empty. There was a small gestational sac in the region of the cervical canal, and a normal vagina was identified below it, The cervical pregnancy was confirmed during surgery, when a conventional dilatation and curettage failed to arrest hemorrhage, and hysterectomy had to be performed.
DISCUSSION
By carefully identifying normal anatomy (in this case the vagina, cervix, uterine body, and uterine fundus), the diagnosis of a n ectopic gestation can be made very early in pregnancy. Early diagnosis of ectopic pregnancy is vitally important for early treatment and a better prognosis for the patient. ACKNOWLEDGMENT
We would like to thank John Carlson for his artistic assistance. REFERENCE 1. Jeffcoate TNA: Principles of Gynaecology. London, Butterworth, 1962.
JOURNAL OF CLINICAL ULTRASOUND
ECTOPIC CERVICAL PREGNANCY T.T.S. Chow, M.B.B.S., M.R.C.O.G., F.R.C.S.(C 1, and S. Lindahl, R.T.R., R.D.M.S.
A pregnancy can occur in one of several ectopic locations, and diagnosis of the unsuitable location should be made as early as possible before rupture occurs. The commonest site for ectopic implantaFrom the Salvation Army Grace Hospital, Vancouver, British Columbia, Canada. For reprints contact S. Lindahl, R.T.R., R.D.M.S., Salvation A m y Grace Hospital, 678 West 26th Avenue, Vancouver, B.C. V5Z 2E6, Canada. @ 1979 by John Wiley & Sons, Inc. 0091-2751/79/030217-02 $01.OO.
tion is the fallopian tube. Other possible sites are the ovary, the broad ligament, the abdomen, the cervic uteri, or the uterine cornua-rudimentary horn (1) (Fig. 1).
CASE REPORT
A 43-year-old woman, para 2, gravida 5, presented on May 3, 1978, with a 12-week history of amenorrhea, her last normal menstrual period
FIGURE 1. Possible locations of ectopic pregnancy: (1) ovary. (2) fimbria. (3) ampulla, (4) isthmus, ( 5 ) interstitial segment, (6) cornua (rudimentary horn), (7) cervix, ( 8 ) broad ligament, (9) abdomen.
FIGURE 2. A: Sagittal section showing the ectopic gestation lodged in the cervix. 8: bladder; V: vagina; Cx: cervix; Ut: corpus uteri; GS: gestational sac. 8: Transverse section through the cervix showing the gestational sac. B: bladder; Cx: cervix; GS: gestational sac.
21 7
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being February 4, 1978. On March 30 she exDerienced heavy vaginal bleeding that lasted ior 5 days and was followed by mucoid dark-red spotting until April 28, when the bleeding recurred and continued. A pregnancy test was ordered, and as the result was negative, an ultrasound examination was requested. A gray scale scan was performed, with films being taken in the longitudinal and transverse directions (Figs. 2A, 2B).The corpus uteri was slightly bulky and appeared to be empty. There was a small gestational sac in the region of the cervical canal, and a normal vagina was identified below it, The cervical pregnancy was confirmed during surgery, when a conventional dilatation and curettage failed to arrest hemorrhage, and hysterectomy had to be performed.
DISCUSSION
By carefully identifying normal anatomy (in this case the vagina, cervix, uterine body, and uterine fundus), the diagnosis of a n ectopic gestation can be made very early in pregnancy. Early diagnosis of ectopic pregnancy is vitally important for early treatment and a better prognosis for the patient. ACKNOWLEDGMENT
We would like to thank John Carlson for his artistic assistance. REFERENCE 1. Jeffcoate TNA: Principles of Gynaecology. London, Butterworth, 1962.
JOURNAL OF CLINICAL ULTRASOUND
