Cervical ectopic pregnancy is a rare subtype of ectopic pregnancy, in which a gestational sac is seen at the endocervical canal below the closed internal os. Implantation of the fertilized ovum occurs within the cervix rather than the uterine cavity.
On Ultrasound, the endometrial cavity is empty and there is evidence of a gestational sac within the distended cervix which may give an hour-glass appearance to the uterus. There is hyperechoic decidual reaction around the gestational sac. Yolk sac /fetal pole may be seen depending upon the gestational age it is detected. Usually, internal os is closed. At times the gestational sac extends into the lower uterine segment (abnormally low sac position).
On Color Doppler imaging can be helpful in showing a hyper vascular trophoblastic ring in the cervical region in cases of live cervical ectopic pregnancies.
Also Read : What to Expect when You get an Ultrasound Scan?
What are the risk factors of cervical ectopic pregnancy?
There are many risk factors for the cervical pregnancy which include variant anatomy , fibroids, IUCD
Asherman syndrome , IVF, repeated dilatation and curettage .
Differential diagnosis include miscarriage in progress as a differential when the gestational sac is located within the endocervical canal; However features suggestive of a miscarriage include:
- absent embryonic cardiac activity
- open internal os: lack of typical hourglass appearance
- sac shape and location often changes on serial scans and it may be possible to alter the location of the sac with gentle probe manoeuvring (“sliding sac sign”)
- subsequent loss of the fetal sac on a repeat ultrasound confirms miscarriage.
About Dr. Shairy Goyal
MBBS, MD (Radiology),Fetal Ultrasound Program (Bangalore Fetal Medicine Centre), Fellowship in Musculoskeletal Radiology (Thomas Jefferson, Philadelphia)
Dr. Shairy Goyal is one of the best radiologist in Delhi NCR Gurgaon with wide experience in the field of radiology including ultrasound scans. Her ambition is to provide world class ultrasound and imaging facilities to the patients. She has an ample experience in the gynaecology and pregnancy scans along with abdominal and musculoskeletal scans.