Analysis of 58 cases of cervical pregnancy and literature review

This study aimed to investigate the efficacy and prognosis of different treatment modalities in patients with cervical pregnancy. Clinical data of 58 patients diagnosed with cervical pregnancy admitted to the Obstetrics and Gynecology ward of the Third Affiliated Hospital of Zhengzhou University during the period from September 2014 to September 2024 were retrospectively analyzed as the study subjects, and according to the different treatment modes of the patients, patients were categorized into Group A[ n = 13, treated with methotrexate (MTX) + mifepristone drug therapy in addition to ultrasound-guided uterine curettage], Group B [ n = 19, treated with UAE in addition to ultrasound-guided uterine curettage] and Group C [ n = 26, treated with direct ultrasound-guided uterine curettage(D&C alone)]. The general clinical data and intraoperative and postoperative conditions of the patients in the three groups were collected by retrospective analysis and statistical analysis. A total of 58 patients with cervical pregnancy were included and divided into three groups: Group A (MTX + mifepristone + D&C, n = 13), Group B (UAE + D&C, n = 19), and Group C (D&C alone, n = 26). There were no significant differences among the three groups in baseline characteristics, including age, gestational age, mode of conception, gravidity, preoperative β-hCG levels, and gestational sac size(Width and Thickness) ( P > 0.05). No patient in any group required a hysterectomy. Intraoperative blood loss showed no significant difference among groups ( P > 0.05), although severe bleeding (≥ 300 mL) occurred more frequently in Group C ( n = 8) than in Group A (n = 2) and Group B ( n = 3). Group A had significantly longer hospital stays compared with Group B and Group C ( P < 0.05). Hospitalization costs were significantly lower in Group C than in Groups A and B ( P < 0.05). There was no significant difference in postoperative day 3 β-hCG levels among the three groups ( P > 0.05). However, the time to β-hCG normalization was significantly shorter in Groups A and B than in Group C ( P < 0.05). In the case of cervical pregnancy, individualized and combined treatment regimens should be chosen according to the patient's condition to achieve optimal therapeutic outcomes.