Background: Heterotopic pregnancy is the condition in which
intrauterine and ectopic pregnancy coexist. The conservative
management of the ectopic pregnancy, with the intrauterine
pregnancy preserved, has been reported. Case(s): Here,
we report a very rare case: intrauterine and cervical pregnancy
coexist: intrasacular Potassium chloride (KCL) injection successfully terminated
cervical pregnancy with intrauterine pregnancy preserved, but
later massive bleeding occurred from the cervix. A 39-year-old
woman at 7 weeks was diagnosed with a heterotopic cervical
gestation, with intrauterine and cervical sac, both with live
embryos. The ectopic pregnancy was successfully terminated with
intrasacular injection of KCl, preserving the intrauterine pregnancy.
At 32 weeks of gestation the patient started with a profuse bleeding
from the cervical sac, causing maternal hypotension (80/45 mmHg) and
tachycardia (160 bpm) and a decelerative pattern in the cardiotocographic
fetal monitoring, prompting us to perform caesarean section.
The cessation of bleeding was achieved using a double balloon
intracervical catheter, which was withdrawn 24 hours after its
insertion without observing a new bleeding episode. The patient
was discharged after 8 days and the newborn after 35 days of life,
both in good health. Conclusions: Conservative treatment of
a heterotopic gestation is possible, managing to preserve the viability
of the intrauterine pregnancy.