INTRODUCTION: -

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.

PATHOPHYSIOLOGY: - 

• 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.