Ultrasound appearance of cervical pregnancy

In case of cervical pregnancy, an ultrasound examination is needed in time to see the specific manifestations. In fact, many female friends do not pay attention to their prenatal examinations, which may be irresponsible to their fetus and their own bodies. Even if an abnormal reaction occurs, it is too late to deal with it, especially the need for ultrasound examinations, B-ultrasound examinations and hcg examinations. These examination items are very important links.

1. Peripheral blood

Normocytosis, normochromic anemia, normal platelets, normal or elevated white blood cells.

2. Positive pregnancy test.

3. Gynecological examination

The cervix becomes larger, with obvious coloration, soft texture, and dilatable cervical opening. Sometimes dark red or purple tissue can be seen. There seems to be tissue stuck in the cervical opening, but heavy bleeding may occur when trying to separate the tissue and cervix with fingers. The most characteristic change is that during the gynecological triple examination, the uterus is gourd-shaped, the uterus is small and slightly hard, the cervix is ​​large and soft, and sometimes the uterine artery pulsation can be felt. This is a typical manifestation of cervical pregnancy.

4. Blood β-hCG detection

The development of blood β-hCG detection technology and B-ultrasound has made early diagnosis of cervical pregnancy possible.

5. Ultrasound examination or vaginal ultrasound

(1) Cervical dilatation;

(2) There is a complete gestational sac in the cervical canal, and sometimes the embryo or fetal heart can be seen;

(3) Closure of the internal cervical os;

(4) The uterine cavity is empty. Color Doppler ultrasound is used to detect trophoblast invasion into the cervical stroma and the location of the uterine arteries. The uterine artery crosses the ureter and reaches the lateral edge of the uterus 2 cm above the level of the internal os of the cervix. This anatomical location can help determine that the site of pregnancy is below the histological internal os of the cervix to aid in the diagnosis of cervical pregnancy.

After the diagnosis is confirmed, scraping and curettage of the cervical canal or suction curettage of the cervical canal can be performed. Preparations for blood transfusion or uterine artery embolization should be performed before the operation to reduce intraoperative bleeding. After the operation, gauze strips are used to pack the cervical canal wound to stop bleeding. If the bleeding does not stop, bilateral internal iliac artery ligation can be performed. If the effect is not good, total hysterectomy should be performed promptly to save lives.

In order to reduce bleeding during curettage and avoid hysterectomy, preoperative MTX treatment has been used in recent years. After MTX treatment, the embryo died, the surrounding villous tissue necrotized, and the amount of bleeding during curettage was significantly reduced.