Cervical pregnancy. Long-term outcomes of fertility-preserving hysteroscopic treatment

Cervical pregnancy is a rare type of ectopic pregnancy, with an incidence of 1% in relation to other types of ectopic pregnancy and one case per 18,000 of all pregnancies. Objective. To study the long-term outcomes of the treatment of patients with cervical pregnancy who underwent operative hysteroscopy with fertility preservation. Patients and methods. This prospective and retrospective open-label clinical study included 46 patients with cervical pregnancy. Patients were divided into two groups: the retrospective group (n = 29) and the prospective group (n = 17). In all cases, treatment was performed by operative hysteroscopy. Results. After hysteroscopic treatment, an intended pregnancy occurred in all women who did not use contraceptive methods. The rate of natural pregnancy was 41.3% and the rate of pregnancy following ART was 32.6% (at baseline, 36.9% of patients had ectopic pregnancy after ART procedures). A total of 39.1% of patients gave birth; no cases of ante-, intra-, or postnatal fetal death were registered during labor. The cesarean section rate was 51.8%. Conclusion. Operative hysteroscopy should be considered as the method of choice in the treatment of patients with cervical pregnancy with gestational age up to 7 weeks (in case of advanced pregnancy – up to 8 weeks), chorion localization within ½ cervical muscle thickness and absence of severe bleeding with signs of hemorrhagic shock. Key words: cervical pregnancy, operative hysteroscopy, reproductive outcomes