Table 1. Overview of heterotopic cervical pregnancy case reports
Author (year) Maternal age Method of conception Gestational age at diagnosis Treatment Pregnancy outcome Presenting symptom / Complications
Current paper 39 IVF 7w 5d Spontaneous elimination of the CG after patient sedation, cervical (US guided) C-section (39w) Asymptomatic
Saito
et al.,2018
39 IVF 5w 2d CG extraction with forceps (US guided) C-section (36w) Vaginal bleeding / Blood transfusion, total placenta accreta, hysterectomy
Punhani
et al., 2016
34 IVF 8w Local injection of KCl, uterine artery embolization,MTX IM, curettage Intentional interruption Vaginal bleeding / Blood transfusion
Pinto
et al., 2016
35 IVF+ICSI 7w 2d Cervical curettage (US guided) C-section (39w) Asymptomatic
Subedi
et al., 2016
33 IVF 5w Uterine artery embolization, aspiration, hysteroscopic removal with forceps Intentional interruption Vaginal bleeding
Elena
et al., 2016
37 IVF 5w Aspiration and cervical curettage, cerclage Vaginal delivery (35.4w) Asymptomatic / Bleeding, pelvic pain
Tsakos
et al., 2015
41 IVF 5w 3d CG aspiration, Foley catheter insertion, cerclage C-section (38w) Asymptomatic
Lin
et al., 2013
32 IVF 8w Cervical curettage, electro-cauterization Maintenance of IU pregnancy (did not specify) Vaginal bleeding, pelvic pain / Triplet gestation: association with tubal gestation
Uysal & Uysal, 2013 31 Spontaneous 6w Local injection of KCl, CG aspiration, Foley catheter insertion, cerclage Delivery (38w) Vaginal bleeding
Moragianni
et al., 2012
40 IVF 7w 3d CG extraction with forceps, Foley catheter insertion, cerclage C-section (39w) Vaginal bleeding
Kim
et al., 2012
36 IVF 5w 2d CG extraction with forceps (US guided) C-section (40w 5d) Vaginal bleeding
Deka
et al., 2012
38 IVF 11w 1d Local injection of KCl and MTX C-section (36w 4d) Vaginal bleeding
Fasching
bauer
et al.,2011
25 Spontaneous / Stimulation (clomiphene citrate) 9w CG aspiration (US guided), cerclage Vaginal delivery (39w 3d) Vaginal bleeding
Sijanovic,
et al., 2011
30 Spontaneous 6-7w Local injection of MTX Vaginal delivery (39w) Vaginal bleeding
Sánchez-Ferrer
et al., 2011
33 IVF 6w 5d Intra-arterial injection of MTX, uterine artery embolization Intentional interruption Vaginal bleeding
Hafner
et al., 2010
34 IVF 6w Foley catheter insertion (US guided), cerclage, ligation of descending cervical branches of the uterine arteries, systemic MTX Intentional interruption Vaginal bleeding
Shah
et al., 2009
34 IVF+ICSI 7w CG aspiration (US guided), prophylactic placement of hypogastric arteries occlusion balloons before delivery C-section (37w) Asymptomatic / Bleeding after aspiration
Hoshino
et al., 2009
37 IVF 6w CG extraction with forceps and curettage (US guided) C-section (38w) Vaginal bleeding
Kim
et al., 2009
30 Spontaneous 8w CG aspiration (US guided), Foley catheter insertion C-section (37w) Asymptomatic / Bleeding during aspiration, cervical hematoma
Majumdar
et al., 2009
36 IVF 7w 5d Local injection of KCl (US guided) C-section (31w) Vaginal bleeding / IUGR, acute fetal distress
Nitke
et al., 2007
45 IVF   Uterine arteries MTX injection Intentional interruption Asymptomatic / Triplet gestation: 2 cervical gestational sacs
Suzuki
et al., 2007
35 IVF 5w 3d CG aspiration and local injection  of 33% glucose solution C-section (34w) Asymptomatic / Bleeding, cervical hematoma
Prorocic & Vasiljevic, 2007 31 IVF 6w CG aspiration and local injection of hypertonic solution of sodium chloride Normal gestational course until 12w (time of report) Vaginal bleeding / Triplet gestation: 2 IU embryos
Honda
et al., 2005
40 IVF+ICSI 6w Local injection of vasopressin, cervical curettage, local injection of MTX Delivery (38w) Vaginal bleeding
Feinberg & Confino, 2004 35 IVF - CG electro-cauterization (US guided) and extraction with forceps Term vaginal delivery Asymptomatic
Gyamfi
et al., 2004
34 IVF 6w Local injection of KCl and aspiration C-section  (31w) Vaginal bleeding, back pain / Bleeding, hysterectomy, blood transfusion
Kumar
et al., 2004
32 Spontaneous 7w Local injection of KCl (US guided) C-section (35w) Bleeding / Impending eclampsia, bleeding, ligation of anterior division of both internal iliac arteries, blood transfusion
Jozwiak
et al., 2003
37 IVF+ICSI 7w 4d CG electro-cauterization (US guided), cerclage (12w) C-section (38w) Asymptomatic
Oláh, 2003 34 IVF 12w Local injection of KCl C-section (36w) Vaginal bleeding / Bleeding, hysterectomy, blood transfusion, DIC
Porpora et al., 2003 29 Spontaneous 6w CG aspiration (US guided) Abortion (1d after aspiration) Asymptomatic / Bleeding
(Seow et al., 2002) 29 IVF 5w CG extraction with forceps (US guided) C-section (37w) Vaginal bleeding, abdominal pain / Triplet gestation: 2 IU embryos
Mashiach et al., 2002 34 IVF 8w 3d Cerclage (Shirodkar) Vaginal delivery (39w) -
Chen et al., 2001 35 IVF 7w 4d CG aspiration (US guided), local injection of KCl, cerclage (10w) C-section (38w) Vaginal bleeding / Bleeding
Al-azemi et al., 1999 32 IVF 6w Local injection of KCl and MTX (US guided), aspiration C-section (30w) Vaginal bleeding / Bleeding after aspiration, premature amniorrhexis
Honey et al., 1999 37 IVF 7w 4d Uterine arteries embolization, local injection of KCl Abortion Vaginal bleeding / Bleeding, blood transfusion, chorioamnionitis, hysterectomy
Bratta et al., 1996 30 - 7w MTX IM (2x) Intentional interruption Asymptomatic / Bleeding
Peleg et al., 1994 35 IVF 7w MTX IM, uterine arteries MTX injection, uterine curettage Intentional interruption Vaginal bleeding / Bleeding, blood transfusion
Bayati et al., 1989 38 IVF 11w 2d Uterine aspiration and curettage, ligation of cervical artery Intentional interruption Vaginal bleeding
CG=cervical gestation; DIC=disseminated intravascular coagulation; ICSI=intracytoplasmic sperm injection; IUGR=intrauterine growth restriction; IM=intramuscular; IU=intrauterine; IVF=in vitro fertilization; KCl=Chloride Potassium; MTX=methotrexate; US=ultrasound