Cervical pregnancy is a rare subtype of extrauterine pregnancy. It is an ectopic pregnancy in the cervix.
What is a cervical pregnancy?
Cervical pregnancy is one of the ectopic pregnancies. With a proportion of 0.2 to 0.5 percent, however, it is only a rare form of extrauterine pregnancy (EUG). This refers to pregnancies that occur outside the uterine cavity (cavum uteri). In most cases, there is an extrauterine pregnancy in the fallopian tube, which is referred to as tubal pregnancy. For meanings of intersex, please visit polyhobbies.com.
It is also called an ectopic pregnancy. Likewise, pregnancies in the abdominal cavity ( abdominal pregnancy ) or in the ovaries (ovarian pregnancy) are possible. Although cervical pregnancy (pregnancy in the cervix) is referred to as extrauterine pregnancy in Germany, it is strictly speaking an intrauterine pregnancy.
However, it is an ectopic pregnancy. Apart from an ectopic pregnancy, there is no viability for the embryo in an ectopic pregnancy, as is the case in a cervical pregnancy. Due to the close anatomical relationship, contact with the uterine artery (Arteria uterina) usually shows up early on. As part of a curettage, there is a risk of severe bleeding that cannot be stopped.
An extrauterine pregnancy like a cervical pregnancy can be triggered by various risk factors. In about a third of all cases, however, these factors are undetectable. Typical risk factors are inflammatory diseases in the pelvic region, the use of intrauterine devices, sterility (infertility) or the intake of the drug diethylstilbestrol (DES).
Also smoking and a previous ectopic pregnancy. Other conceivable triggers are surgical interventions such as sterilization or scraping. A link to endometriosis has also been suggested, but this has not been confirmed. Another source of danger is refertilization after sterilization has taken place.
Symptoms, Ailments & Signs
In the case of an extrauterine pregnancy or cervical pregnancy, there are not always clear symptoms. They can be mild or even absent altogether. An ectopic pregnancy usually becomes apparent between the 5th and 8th week after the last menstrual period. Without the use of modern diagnostic methods, there is a possibility that the cervical pregnancy will not be discovered until late.
Tenderness of the breasts, nausea, vomiting, constant urge to urinate, difficult or painful emptying of the bladder and the absence of a menstrual period are typical indications of an extrauterine pregnancy such as a pregnancy in the cervix. Other symptoms can include pain in the lower abdomen and minor vaginal bleeding.
The latter make it difficult to distinguish cervical pregnancy from a normal pregnancy or a disturbed early pregnancy. Most women experience more pain later because of the bleeding. In addition, there is a drop in progesterone levels. Inflammation, on the other hand, is not responsible for painful symptoms in the case of cervical pregnancy.
Sometimes an ectopic pregnancy also causes symptoms that are similar to those of appendicitis (inflammation of the appendix), gastrointestinal diseases or urinary tract infections. Prostaglandins, which are released at the site of implantation, are responsible for this. Sometimes the peritoneum can also be irritated by free blood within the abdominal cavity.
Diagnosis & course of disease
If there is vaginal bleeding or abdominal pain and if there is a positive pregnancy test, this is considered an indication of an extrauterine pregnancy. A cervical pregnancy can usually be recognized well by a transvaginal sonography ( ultrasound examination ). Important diagnostic features are a barrel-shaped cervix and an empty uterus.
A gestational sac below the level of the ocrificium interni uteri and blood flow near the gestational sac, which can be seen on color Doppler sonography, are also indicators. If the doctor exerts pressure on the uterus with the ultrasound head, the gestational sac cannot be moved in the direction of the cervical canal in the event of an extrauterine pregnancy.
In the further course of a cervical pregnancy, internal bleeding is possible, which can trigger hypovolemic shock. However, with modern medical care, the mortality rate in ectopic pregnancies can be kept low. Whether fertility is preserved after an extrauterine pregnancy also depends on the therapy. After methotrexate treatment, pregnancy is more common than after surgery.
Cervical pregnancy can lead to a number of different symptoms and complications. Those affected usually suffer from severe nausea and vomiting. The woman’s breasts are tense and relatively painful, resulting in a reduced quality of life.
The patient’s urge to urinate is also significantly increased by the disease, whereby urination is often associated with pain. Menstrual periods usually do not occur during cervical pregnancy and there is severe pain in the lower abdomen or in the vaginal area. As a result of the symptoms, many of those affected also suffer from psychological problems or depression.
The disease can also spread to the intestines or stomach, causing disease or inflammation in these areas as well. Bloody stools also occur, which can lead to a panic attack.
Cervical pregnancy is usually treated by abortion of the pregnancy. There are no further complications and the health of the patient is not endangered. However, many sufferers and their partners suffer from mental disorders and therefore need psychological treatment.
When should you go to the doctor?
Cervical pregnancy can only occur in pregnant women. Therefore, they belong to the risk group of the disease and should consult a doctor in case of health issues. Although there are always changes at the beginning of pregnancy, symptoms such as nausea and vomiting should still be checked out by a doctor. Feelings of tightness in the breast area, vaginal bleeding or irregularities when going to the toilet should be examined and treated if necessary.
If there are disorders of the digestive tract, internal irritation or diffuse discrepancies in the abdomen of the woman, it is advisable to consult a doctor. In the event of pain, general malaise or a feeling of illness, there is a need for action. If states of anxiety or panic attacks occur, the person concerned needs help. Psychological abnormalities, behavioral disorders and mood swings are causes for concern. If the irregularities do not normalize within a few days, an examination is recommended. If the symptoms increase or if the general state of health deteriorates, a doctor’s visit is necessary immediately.
Pain-relieving medicines should not be taken without consulting a doctor. If, due to the complaints, everyday obligations can no longer be met, help should be sought. With medical care, the irregularities are alleviated.
Treatment & Therapy
For the women affected, the diagnosis of a cervical pregnancy or extrauterine pregnancy means a severe blow of fate. The life of the embryo cannot be saved in this way. The focus of the treatment is therefore the health and fertility of the patient. Surgical intervention is usually required. This is particularly necessary if there is evidence of cardiac activity or bleeding.
Watching and waiting, on the other hand, usually makes no sense. If the cervical pregnancy can be detected at an early stage and the level of the pregnancy hormone HCG remains low, there is a possibility that the body will dissolve and reject the embryonic tissue after a natural termination of the pregnancy. Further therapeutic measures are then not necessary.
However, abortion can cause significant pain and bleeding. In such a case, an operation must take place. For this reason, regular monitoring examinations are required. However, since cervical pregnancy is difficult to detect in the early stages, monitoring is an exception.
In rare cases, drug therapy can be used. This involves the systemic or local administration of methotrexate. This drug is classified as a cytostatic and inhibits embryo growth. Finally, the methotrexate causes termination of the pregnancy. The abortion is then resorbed by the organism or expelled from the vagina. Contraindications are an ectopic pregnancy with a circumference of more than 3.5 centimeters, blood diseases and diseases of the kidneys or liver.
A cervical pregnancy is difficult to prevent. Giving up smoking cigarettes can be a good idea.
In the case of a cervical pregnancy, those affected usually only have limited options for direct follow-up care. For this reason, those affected should consult a doctor as early as possible and have treatment initiated in order to prevent the further occurrence of other symptoms and complications. It cannot heal on its own.
As a rule, those affected with cervical pregnancy are dependent on an abortion of the pregnancy. Regular and strict checks by a doctor are still very important in order to monitor and control the physical condition on a permanent basis. In many cases, it is also necessary to take various medications, whereby it is always important to ensure the correct dosage and regular intake. If you have any side effects or questions, you should always consult a doctor first. If the cervical pregnancy is recognized and treated early on, the life expectancy of the affected person is usually not reduced.
You can do that yourself
As a rule, the self-help measures for cervical pregnancy are clearly limited and are only available to the affected person to a very limited extent or not at all. Therefore, in the case of this disease, a quick diagnosis and subsequent treatment should be carried out first and foremost, so that no further complications or symptoms can occur.
Preventing the disease is usually difficult to achieve. A healthy lifestyle with a healthy diet can have a positive effect on this, whereby the patient should avoid smoking and drinking alcohol if possible.
As a rule, a termination of the pregnancy is also necessary in the case of cervical pregnancy. Many of those affected and their partners are dependent on intensive psychological treatment. Contact with other people affected by the disease or with self-help groups can also be very useful. Above all, the support of one’s own family or friends is very important and of great importance with this disease.
Further self-help measures are usually not possible. This disease may develop again if you become pregnant again.