{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T02:09:44Z","timestamp":1791857384477,"version":"4.3.4"},"reference-count":43,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objective: Cervical pregnancy, as a rare type of ectopic pregnancy, can lead to life-threatening complications. Early diagnosis is crucial for optimal management and fertility-sparing strategies. However, despite advances in imaging and early detection, standardized guidelines for management are still lacking. Materials and Methods: This narrative review is based on the collection of case reports of CEP, published in PubMed and Google Scholar in the period 1984\u20132025. We also included heterotopic cervical pregnancy as it poses even greater challenge to the clinicians. Results: Twenty-two articles reporting a total of twenty-four case reports specifically focus on different management techniques and their corresponding success rates. Currently, there is no consensus regarding the optimal management of this type of ectopic pregnancy, and therapeutic decisions are largely influenced by the clinical presentation, available resources, and the expertise of the treating clinicians and institutions. Conclusions: Conservative approaches should be prioritized as first-line therapy in hemodynamically stable patients where fertility preservation is desired. Minimally invasive procedures may be considered as second-line options following failure of conservative management. Hysterectomy remains the last resort for patients with refractory disease or life-threatening hemorrhage. The proposed algorithm provides an expert-based framework for the management of cervical ectopic pregnancy, emphasizing hemodynamic stability, \u03b2-hCG levels, and fertility preservation as key determinants of treatment selection.<\/jats:p>","DOI":"10.3390\/medicina61112072","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T12:02:42Z","timestamp":1763640162000},"page":"2072","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Current Trends in the Treatment of Cervical Pregnancy: A Narrative Review"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6812-8658","authenticated-orcid":false,"given":"Nikoleta","family":"Stoyanova","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Medical University Pleven, 5800 Pleven, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7719-382X","authenticated-orcid":false,"given":"Angel","family":"Yordanov","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology, Medical University Pleven, 5800 Pleven, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikola","family":"Popovski","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Medical University Pleven, 5800 Pleven, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Stabile, G., Mangino, F.P., Romano, F., Zinicola, G., and Ricci, G. (2020). Ectopic Cervical Pregnancy: Treatment Route. Medicina, 56.","DOI":"10.3390\/medicina56060293"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"101665","DOI":"10.1016\/j.jogoh.2019.101665","article-title":"Risk factors for cervical ectopic pregnancy","volume":"49","author":"Hoyos","year":"2020","journal-title":"J. Gynecol. Obstet. Hum. Reprod."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.rbmo.2019.12.011","article-title":"Cervical pregnancy in assisted reproduction: An analysis of risk factors in 91,067 ongoing pregnancies","volume":"40","author":"Matorras","year":"2020","journal-title":"Reprod. Biomed. Online"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1016\/j.jmig.2015.05.018","article-title":"Outcomes of Bilateral Uterine Artery Chemoembolization in Combination with Surgical Evacuation or Systemic Methotrexate for Cervical Pregnancy","volume":"22","author":"Chen","year":"2015","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_5","first-page":"e52125","article-title":"Cervical Ectopic Pregnancy: Combination Treatment with Multi-Dose Methotrexate Regimen, Uterine Artery Embolization, and Suction Curettage","volume":"16","author":"Bunn","year":"2024","journal-title":"Cureus"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1093\/humrep\/16.3.584","article-title":"Cervical ectopic twin pregnancy: Diagnosis and conservative treatment: Case report","volume":"16","author":"Pascual","year":"2001","journal-title":"Hum. Reprod."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"102837","DOI":"10.1016\/j.jogoh.2024.102837","article-title":"Cervical ectopic pregnancy: A case report of a massive pregnancy with a minimally invasive blood-free treatment and a review of the literature","volume":"53","author":"Astruc","year":"2024","journal-title":"J. Gynecol. Obstet. Hum. Reprod."},{"key":"ref_8","first-page":"4190","article-title":"Effective combined treatment in ectopic cervical pregnancy preserving fertility: A case report and literature review","volume":"25","author":"Mininni","year":"2021","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e00340","DOI":"10.1016\/j.crwh.2021.e00340","article-title":"Single-dose intramuscular methotrexate for treatment of cervical ectopic pregnancy: A case report","volume":"31","author":"Dilday","year":"2021","journal-title":"Case Rep. Womens Health"},{"key":"ref_10","first-page":"78","article-title":"Single-dose intramuscular methotrexate treatment of cervical ectopic pregnancy. A case report","volume":"60","author":"Asante","year":"2015","journal-title":"J. Reprod. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e32177","DOI":"10.1097\/MD.0000000000032177","article-title":"Treatment of heterotopic cervical pregnancy by ultrasound-guided hysteroscopy: A case report and literature review","volume":"101","author":"Sheng","year":"2022","journal-title":"Medicine"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1111\/jog.15193","article-title":"Heterotopic cervical pregnancy: Case report and literature review","volume":"48","author":"Fan","year":"2022","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"277","DOI":"10.18597\/rcog.3357","article-title":"Conservative management in a patient with cervical ectopic pregnancy in Nari\u00f1o, Colombia: Case report and review of the literature","volume":"70","year":"2019","journal-title":"Rev. Colomb. Obstet. Ginecol."},{"key":"ref_14","first-page":"290","article-title":"Heterotopic cervical pregnancy after in-vitro fertilization-case report and literature review","volume":"23","author":"Terra","year":"2019","journal-title":"JBRA Assist. Reprod."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1046\/j.1469-0705.2002.00559.x","article-title":"Cervical ectopic pregnancy: A case report and literature review","volume":"19","author":"Gun","year":"2002","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2011.e1","DOI":"10.1016\/j.fertnstert.2008.06.018","article-title":"Cervical ectopic pregnancy on the portio: Conservative case management and clinical review","volume":"90","author":"Kraemer","year":"2008","journal-title":"Fertil. Steril."},{"key":"ref_17","first-page":"791","article-title":"Cervical pregnancy: Case report and literature review","volume":"76","author":"Kouyoumdjian","year":"1984","journal-title":"J. Natl. Med. Assoc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"521","DOI":"10.26444\/aaem\/127926","article-title":"The use of super-selective uterine artery branch embolization and methotrexate in cervical pregnancy-case reports and literature review","volume":"28","author":"Oleksik","year":"2021","journal-title":"Ann. Agric. Environ. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1787.e9","DOI":"10.1016\/j.fertnstert.2010.10.043","article-title":"Treatment of heterotopic cervical pregnancies","volume":"95","author":"Faschingbauer","year":"2011","journal-title":"Fertil. Steril."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1016\/j.jmig.2015.03.009","article-title":"Suggested method for the management of heterotopic cervical pregnancy leading to term delivery of the intrauterine pregnancy: Case report and literature review","volume":"22","author":"Tsakos","year":"2015","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.fertnstert.2012.04.003","article-title":"Management of a cervical heterotopic pregnancy presenting with first-trimester bleeding: Case report and review of the literature","volume":"98","author":"Moragianni","year":"2012","journal-title":"Fertil. Steril."},{"key":"ref_22","first-page":"297","article-title":"Conservative management of cervical ectopic pregnancy: Case report and review of literature","volume":"35","author":"Corticelli","year":"2008","journal-title":"Clin. Exp. Obstet. Gynecol."},{"key":"ref_23","first-page":"409","article-title":"Successful pregnancy after treatment of cervical pregnancy with methotrexate and curettage: A case report","volume":"40","author":"Mantalenakis","year":"1995","journal-title":"J. Reprod. Med."},{"key":"ref_24","first-page":"365","article-title":"Transvaginal ligation of the cervical branches of the uterine artery and injection of vasopressin in a cervical pregnancy as an initial step to controlling hemorrhage: A case report","volume":"53","author":"Davis","year":"2008","journal-title":"J. Reprod. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1097\/01.AOG.0000220599.74326.94","article-title":"Treatment of early cervical pregnancy with cerclage, carboprost, curettage, and balloon tamponade","volume":"109","author":"Avery","year":"2007","journal-title":"Obstet. Gynecol."},{"key":"ref_26","first-page":"254","article-title":"Diagnosis and treatment of early cervical pregnancy: A case report and literature review","volume":"32","year":"2005","journal-title":"Clin. Exp. Obstet. Gynecol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Cvetkov, D., Lukanovic, D., and Yordanov, A. (2025). Outpatient Hysteroscopic Treatment of Cervical Ectopic Pregnancy in a Primigravida Using the Ho:YAG Laser: A Case Report and Operative Protocol Evaluation. Reprod. Med., 6.","DOI":"10.3390\/reprodmed6030021"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1002\/jcu.1870170410","article-title":"Use of ultrasound and magnetic resonance imaging in the diagnosis of cervical pregnancy","volume":"17","author":"Shah","year":"1989","journal-title":"J. Clin. Ultrasound"},{"key":"ref_29","first-page":"79","article-title":"Cervical pregnancy analysis: A review and report of five cases","volume":"62","author":"Parente","year":"1983","journal-title":"Obstet. Gynecol."},{"key":"ref_30","first-page":"QD03","article-title":"Successful Management of Live Cervical Ectopic Pregnancy: A Case Report","volume":"9","author":"Samal","year":"2015","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/0002-9378(78)90377-0","article-title":"Diagnosis of cervical pregnancy by ultrasound: A Case report","volume":"130","year":"1978","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1046\/j.1469-0705.1997.08060373.x","article-title":"Diagnosis and treatment of early cervical pregnancy","volume":"8","author":"Jurkovic","year":"1996","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"rjab216","DOI":"10.1093\/jscr\/rjab216","article-title":"Successful management of cervical ectopic pregnancy with embryo reduction: Report of three cases","volume":"2021","author":"Ortiz","year":"2021","journal-title":"J. Surg. Case Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1089\/gyn.2016.0003","article-title":"Management of cervical pregnancy with a combination of systemic methotrexate and ultrasound-guided local instillation of methotrexate and potassium chloride: A case report and review of the literature","volume":"32","author":"Yavanasuriya","year":"2016","journal-title":"J. Gynecol. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"81","DOI":"10.12998\/wjcc.v3.i1.81","article-title":"Conservative management of cervical pregnancy with intramuscular administration of methotrexate and KCl injection: Case report and review of the literature","volume":"3","author":"Petousis","year":"2015","journal-title":"World J. Clin. Cases"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.ejogrb.2012.06.024","article-title":"Medical therapy (methotrexate and mifepristone) alone or in combination with another type of therapy for the management of cervical or interstitial ectopic pregnancy","volume":"165","author":"Benitez","year":"2012","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Boil."},{"key":"ref_37","first-page":"92","article-title":"A Systematic Review about Cervical Pregnancy and our Experience","volume":"31","author":"Nikolettos","year":"2024","journal-title":"Acta Med. Litu."},{"key":"ref_38","first-page":"e202100016","article-title":"Management of Cervical Ectopic Pregnancy with Small-Caliber Hysteroscopy","volume":"25","author":"Maglic","year":"2021","journal-title":"J. Second. Lang. Stud."},{"key":"ref_39","first-page":"9593824","article-title":"Successful Management of Cervical Ectopic Pregnancy with Bilateral Uterine Artery Embolization and Methotrexate","volume":"2018","author":"Takeda","year":"2018","journal-title":"Case Rep. Emerg. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1097\/OGX.0000000000000062","article-title":"Diagnostic and therapeutic dilemmas of cervical ectopic pregnancy","volume":"69","author":"Hosni","year":"2014","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/AOG.0000000000001782","article-title":"Vaginal Hysterectomy for Treatment of Cervical Ectopic Pregnancy","volume":"129","author":"Alammari","year":"2017","journal-title":"Obstet. Gynecol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"93","DOI":"10.31083\/j.ceog4904093","article-title":"Cervical pregnancy management by lauromacrogol combined with intrauterine visualization system and vacuum aspiration: Two case studies","volume":"49","author":"Cai","year":"2022","journal-title":"Clin. Exp. Obstet. Gynecol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1111\/jog.14617","article-title":"Cervical pregnancy management: An updated stepwise approach and algorithm","volume":"47","year":"2021","journal-title":"J. Obstet. Gynaecol. Res."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/11\/2072\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T12:32:36Z","timestamp":1763641956000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/11\/2072"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,20]]},"references-count":43,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["medicina61112072"],"URL":"https:\/\/doi.org\/10.3390\/medicina61112072","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,20]]}}}