Non-viable cervico-isthmic pregnancy: the importance of an accurate sonographic diagnosis to preserve fertility.
BACKGROUND
Cervico-isthmic pregnancy is a rare occurrence and until the use of current ultrasonographic techniques was associated with a disastrous outcome for women desiring to maintain their fertility.


METHODS
A 39-year-old woman was diagnosed at 12 weeks of amenorrhoea with an intra-uterine non-viable pregnancy and a low implantation of the gestational sac. Medical management of this situation with a regimen of intravaginal misoprostol was unsuccessful. At introduction of a cervical expander severe vaginal bleeding ensued, leading to an emergency curettage followed by a life-saving hysterectomy. Pathologic examination confirmed the peroperative impression of an isthmic implantation of the gestational sac.


CONCLUSIONS
Early ultrasonographic diagnosis is essential to make conservative management of cervico-isthmic pregnancy possible.
Loureiro
Teresa
T
Department of Obstetrics and Gynecology, S. João Hospital, Porto, Portugal.
Cunha
Manuela
M
Marques
Eduarda
E
Araújo
Maria Libânia
ML
Montenegro
Nuno
N
Laurini
Ricardo
R
Exposito
Maria Isabel
MI
del Pilar Martinez
Maria
M
D000328:Adult; D003951:Diagnostic Errors; D005260:Female; D005298:Fertility; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007044:Hysterectomy; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D014463:Ultrasonography