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A 31-year-old primigravida presented at 6+5 weeks with vaginal bleeding; targeted ultrasound-guided surgery preserved the intrauterine pregnancy, followed by cervical cerclage after shortening.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/management-of-heterotopic-cervical-pregnancy-a-case-report-and-review-of-the-literature/452068/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/management-of-heterotopic-cervical-pregnancy-a-case-report-and-review-of-the-literature/452068.png","ImageObject",300,407,{"name":42,"@type":43},"Blitz","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What defines heterotopic cervical pregnancy and why is it high risk?","Question",{"text":63,"@type":64},"It is defined by an intrauterine pregnancy coexisting with an ectopic gestation implanted in the uterine cervix. 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At 16 weeks, a Shirodkar cerclage was placed due to cervical shortening, and the pregnancy continued to delivery via cesarean section.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},452068,1790763415,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":107,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144,"preview_page_count":4},24464137899374,"https://us-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Principi et al. Journal of Medical Case Reports (2026) 20:10  \n[https://doi.org/10.1186/s13256-025-05752-8](https://doi.org/10.1186/s13256-025-05752-8)  \nJournal of Medical Case Reports  \n CASE REPORT Open Access  \nManagement of heterotopic cervical pregnancy: a case report and review of the literature  \nGiulia Principi 1, Massimo M. Salvatori2, Fernando Ficarola3,4 and Giovanni Larciprete2*  \nAbstract  \nBackground Heterotopic cervical pregnancy is an extremely rare condition, defined by the simultaneous presence of an intrauterine gestation and an ectopic gestation located in the uterine cervix. Cervical pregnancies are associated with a high risk of severe hemorrhage owing to the close proximity of the trophoblastic tissue to the uterine blood vessels. Early diagnosis is often challenging, as clinical symptoms are frequently absent or nonspecific. Currently there are no standardized management guidelines for coexisting intrauterine and cervical pregnancies; treatment decisions depend largely on the patient’s desire to continue the intrauterine pregnancy and the clinical expertise of the healthcare team.  \nCase presentation We report the case of a 31-year-old primigravida of Sri Lankan ethnicity with a spontaneous heterotopic pregnancy, who presented at 6 + 5 weeks of gestation with vaginal bleeding. Her medical and surgical history were unremarkable. Transvaginal ultrasound revealed a viable intrauterine pregnancy coexisting with a viable cervical ectopic pregnancy. Given the acute bleeding and the patient’s wish to preserve the intrauterine pregnancy, surgical management was chosen. Ultrasound-guided cervical curettage with preemptive bilateral cervical suturing was performed, achieving an effective hemostasis. At 16 weeks, a Shirodkar cerclage was placed due to cervical shortening. The pregnancy progressed without complications, and a healthy newborn was delivered via cesarean section at 38 + 6 weeks of gestation.  \nConclusion Given the rarity and potentially life-threatening nature of heterotopic cervical pregnancy, the dissemination of clinical experiences is essential to improve diagnostic accuracy and inform management strategies. This case highlights the importance of early recognition and tailored surgical intervention. Ultrasound-guided evacuation with targeted cervical suturing effectively controlled the hemorrhage while preserving the intrauterine pregnancy, whilst second-trimester cerclage addressed cervical shortening. Our experience supports a conservative and individualized approach guided by patient preferences, clinical stability, and multidisciplinary expertise as a viable strategy for optimizing maternal and fetal outcomes in this rare and high-risk condition.  \nKeywords Cervical pregnancy, Heterotopic, Extrauterine gestation, Shirodkar cervical cerclage, Case report  \n*Correspondence:  \nGiovanni Larciprete  \n[giovanni.larciprete@fbf-isola.it](giovanni.larciprete@fbf-isola.it)  \nFull list of author information is available at the end of the article  \n© The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of ","cbCaihe5b5hS5Vae","https://ap.wps.com/l/cbCaihe5b5hS5Vae","pdf",1022157,"English","# Abstract\n# Background\n# Case presentation","[{\"question\":\"What defines heterotopic cervical pregnancy and why is it high risk?\",\"answer\":\"It is defined by an intrauterine pregnancy coexisting with an ectopic gestation implanted in the uterine cervix. Cervical implantation creates a high risk of severe hemorrhage because trophoblastic tissue is close to uterine blood vessels.\"},{\"question\":\"How was the diagnosis made in the reported case?\",\"answer\":\"Transvaginal ultrasound showed a viable intrauterine pregnancy coexisting with a viable cervical ectopic pregnancy.\"},{\"question\":\"What treatment strategy was used to control bleeding and protect the intrauterine pregnancy?\",\"answer\":\"Ultrasound-guided cervical curettage with preemptive bilateral cervical suturing achieved effective hemostasis. At 16 weeks, a Shirodkar cerclage was placed due to cervical shortening, and the pregnancy continued to delivery via cesarean section.\"}]","Management of heterotopic cervical pregnancy - a case report and review of the literature | PDF",1790736422,18]