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Case Reports
. 2025 Mar 20;20(6):2861-2869.
doi: 10.1016/j.radcr.2025.02.081. eCollection 2025 Jun.

Heterotopic cervical pregnancy: Case report and literature review

Ghazaleh Salehabadi  1 , Nedasadat Rezaei  1 , Ayda Roostaee  1 , Nooshin Eshraghi  2 , Zeinab Safarpour Lima  1
Affiliations
Case Reports

Heterotopic cervical pregnancy: Case report and literature review

Ghazaleh Salehabadi et al. Radiol Case Rep. .

Abstract

Heterotopic cervical ectopic pregnancy (CEP) is a rare form of ectopic pregnancy, that involves implantation of gestational sac in both the cervical canal and uterine cavity. This condition poses high risks of severe complications like lethal vaginal bleeding and abortion. Transvaginal ultrasonography is the primary diagnostic tool. Risk factors may vary from prior cesarean delivery to the utilization of Assisted Reproductive Technologies (ART). Despite the research conducted on this condition, the best treatment strategy has not been established. This study discusses a rare case of cervical heterotopic pregnancy, emphasizing early diagnosis. Our case underwent in-vitro fertilization (IVF). We used potassium chloride (KCL) and methotrexate (MTX) as treatment. At first, the cervical gestational sac was expelled but unfortunately, later, the intrauterine gestational sac was also aborted. We also reviewed 25 cases (1980-2024) which demonstrated the importance of early diagnosis of heterotopic cervical pregnancy and that most cases are likely to have positive outcomes.

Keywords: Case report; Heterotopic pregnancy; In-vitro fertilization; Transvaginal ultrasonography.

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Figures

Fig 1
Fig. 1
Transvaginal ultrasound revealed a GS in the proximal uterine cavity (white arrow) and a GS in the posterior wall of distal cervix (yellow arrow) suggestive of cervical heterotopic pregnancy.
Fig 2
Fig. 2
Transvaginal ultrasound revealed a gestational sac in the proximal uterine cavity containing a yolk sac but no fetal pole (FP).
Fig 3
Fig. 3
Transvaginal ultrasound revealed GS containing a viable embryo with a CRL of 3 mm and gestational age of 5 weeks and 6 days, in the posterior wall of distal cervix (yellow arrow).
Fig 4
Fig. 4
Transvaginal ultrasound showed an intrauterine pregnancy, containing a FP with FHR (white arrow).
Fig 5
Fig. 5
Transvaginal ultrasound showed the cervical gestational sac measuring 15 × 14 mm and no cardiac activity was detected in the FP anymore suggestive of embryo demise (yellow arrow).
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