It is a rare variant of ectopic pregnancy.
In this type of pregnancy implantation occurs in the cervical canal at or below the internal Os.
- Erosion of the walls by trophoblasts occurs resulting in thinning and distension of the canal.
- In cervical pregnancy the bleeding is painless and the uterine body lies above the distended cervix.
- Intractable bleeding following expulsion or evacuation of the products brings about suspicion. The morbidity and mortality is high because of profuse hemorrhage.
CAUSES OF CERVICAL PREGNANCY: - Common risk factors for cervical pregnancy are prior dilatation and curettage, prior caesarean section and in vitro fertilization.
COMPLICATIONS CERVICAL PREGNANCY: - Complications linked to incompetent cervix can include pre mature birth and miscarriage.
CLINICAL DIAGNOSTIC CRITERIA: -
- Soft, enlarged cervix equal to or larger than the fundus.
- Uterine bleeding following Amenorrhea, without cramping pain.
- Products of conception entirely confined within and firmly attached to endocervix.
- A closed internal cervical OS and a partially opened external Os.
- Sonography reveals the pregnancy in the cervical canal and an empty Uterine cavity.
- Hysterectomy is often required to stop bleeding.
- Confirmation is done by histological evidence of presence of Villi inside the Cervical stroma.
PREGNANCY OF UNKNOWN LOCATION: -
No sign of either intra or extra uterine pregnancy or Retained products of conception in a woman with a positive pregnancy test.
Pregnancy of uncertain viability:- Intrauterine gestation sac ( less than 20 mm mean diameter) with no obvious yolk sac or foetus or foetal echo less than 6mm crown-rump length with no obvious foetal heart activity.
HOMOEOPATHIC MEDICINES FOR MANAGING CERVICAL PREGNANCY: -
1) Aconite: - this remedy calms extreme anxiety which is common in pregnancy.
2) Arnica: - this remedy heals the soft tissue damage and reduces swelling and bruising caused during the birth.
3) Bellis per: - this remedy is useful when Arnica does not alleviate discomfort and it is considered to work effectively for sores and bruises, easing Pelvic pain or abdominal tissue damage.
4) Caulophyllum: - This remedy helps to tone up and strengthen the uterus and prepares the cervix for birth. It is also used to induce contractions during child birth.