A 28-year-old woman with a history of right salpingectomy presents at 7 weeks with pain and beta-hCG of 4,500 mIU/mL. Transvaginal ultrasound shows a heterogeneous mass in the cervix with peritrophoblastic vascularity and no intrauterine gestational sac. This presentation is MOST consistent with:

• A Cesarean scar ectopic pregnancy
• B Cervical ectopic pregnancy ✓
• C Incomplete abortion with retained products
• D Interstitial ectopic pregnancy

Explanation

Cervical ectopic pregnancy implants in the endocervical canal and is characterised on ultrasound by a gestational sac or heterogeneous mass within the cervix, internal os closed, and marked peritrophoblastic vascularity ('ring of fire') on Doppler — distinct from cesarean scar ectopic, which implants within the hysterotomy scar in the lower uterine segment/anterior wall. Incomplete abortion typically shows open os and absent cardiac activity without peritrophoblastic flow. Interstitial ectopic is in the cornual region of the myometrium.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.