Cervico-isthmic ectopic pregnancy
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We report a case of misdiagnosed CIP manifested by repeated heavy bleeding after curettage. The patient hospitalized at Perinatal Center with complaints of vaginal spotting. Ultrasound scan showed shortened cervix, chorion frondosum presentation just above cervical M-echo and subchorionic hematoma in endometrial cavity above the gestation sac. Attempt of medicamentally induced abortion failed, and dilatation and curettage (D&C) were performed. Massive vaginal bleeding suddenly occurred two weeks later. Trophoblastic invasion into cervix by color Doppler was suspected. Combined management with systemic methotrexate administration and bilateral uterine artery embolization (UAE) was used. Four days after D&C under US control was performed again and no pathology was found two weeks later. The diagnosis could have been formulated on the first admission at the hospital, in spite of low implantation and chorion frondosum presentation....

http://www.edoriumjournalofgyneobst.com/archive/2016-archive/100009G06MT2016-tatiana/100009G06MT2016-tatiana-full-text.php
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