부산대학교 도서관

Cervico-isthmic pregnancy is rare and may potentially cause massive hemorrhage during pregnancy and delivery, resulting in a life-threatening situation. Here we report the case of cervico-isthmic pregnancy that was diagnosed with pathological examination after a laparoscopic hysterectomy. A 38-year-old multiparous woman was admitted to our hospital due to massive genital hemorrhage. A urinary pregnancy test was negative, and color Doppler ultrasonography showed vascular flow toward the intrauterine cavity at the lower uterine body. Blood transfusion and uterine arterial embolization were performed. Because the cervical and endometrial cytology were class 3 and 4, respectively, the patient chose laparoscopic hysterectomy for the diagnosis and curative treatment. The final diagnosis was cervico-isthmic pregnancy. It should be known that hemorrhage occurs without appearing gestation sac in utero in cervico-isthmic pregnancy. There are several treatments for cervico-isthmic pregnancy. It is important to choose the optimal treatment in consideration of patient's background and the risk associated with each treatment.