Cervical ectopic pregnancy

A 26-year-old, gravida 2, para 0 woman with a 12-week pregnancy complicated by incomplete abortion was referred for evacuation of retained products of conception. Suction evacuation was carried out under general anesthesia, but heavy vaginal bleeding continued. Intravenous oxytocin and ergonovine maleate, intramyometrial injection of prostaglandin F2alpha, local pressure to the cervix, uterine massage, and temporary ligation of internal iliac arteries failed to stop the bleeding. The patient received 12 units of blood. The bleeding was finally stopped after inserting a Foley catheter into the cervical canal, inflating its balloon, and applying two cerclage sutures to the cervix above and below the balloon. The woman's postoperative course was complicated by left lung pneumonia, which was treated successfully with antibiotics, and she was discharged home 1 week after admission.