A 26-year-old woman with a previous salpingectomy for ectopic pregnancy presents at 7 weeks with a serum beta-hCG of 6,800 mIU/mL and ultrasound showing no intrauterine gestation sac but a 3.2 cm hyperechoic mass adjacent to the cervix below the uterine cavity. The diagnosis is:
- A Caesarean scar ectopic pregnancy
- B Cornual ectopic pregnancy
- C Cervical ectopic pregnancy ✓
- D Heterotopic pregnancy
Correct answer: C. Cervical ectopic pregnancy
Explanation
A hyperechoic mass below the level of the internal cervical os with no intrauterine pregnancy and elevated hCG indicates cervical ectopic pregnancy. Sonographic criteria include an empty uterine cavity, barrel-shaped cervix, and a gestational sac within cervical tissue below the level of the internal os. Caesarean scar ectopic implants at the anterior lower uterine scar; cornual ectopics are in the interstitial portion of the tube; heterotopic pregnancy involves simultaneous intrauterine and ectopic gestations.
Reference: Williams Obstetrics, 26th ed.
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Written and medically reviewed by the StethoPrep medical team.