title: Acute hemorrhage related to a residual cervical pregnancy: management with curettage, tamponade, and cerclage.
abstract: Cervical ectopic pregnancy is uncommon, with no universally accepted protocol for conservative management of acute hemorrhage due to residual cervical ectopic pregnancy. Herein is presented the case of a 33-year-old woman with profuse vaginal bleeding 3 months after receiving treatment including intraamniotic potassium chloride injection, systemic methotrexate, and uterine artery embolization because of a cervical ectopic pregnancy. A residual cervical pregnancy was suspected. Hemorrhage was controlled using curettage, tamponade with a Bakri balloon, and cerclage. The balloon and cerclage were removed on postoperative day 2, with no recurrence of symptoms. Our experience suggests that a combination of curettage, balloon tamponade, and cerclage may be considered in the management of cervical ectopic pregnancies with acute hemorrhage, in particular in patients desiring future childbearing.
authors.affiliation: Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, Pennsylvania,. Electronic address: Nigel.Pereira@drexelmed.edu.
authors.forename: Nigel
authors.initials: N
authors.lastname: Pereira
authors.forename: Irene
authors.initials: I
authors.lastname: Grias
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Foster
authors.forename: Carl R
authors.initials: CR
authors.lastname: Della Badia
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000032:Abortion, Therapeutic / Q000379:methods; D000328:Adult; D023802:Cerclage, Cervical; D003475:Curettage; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy / Q000601:surgery*; D058738:Uterine Balloon Tamponade; D014592:Uterine Hemorrhage / Q000209:etiology / Q000601:surgery*
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate
keywords: Balloon tamponade; Cerclage; Cervical pregnancy; Curettage; Hemorrhage