Inevitable miscarriage mimicking a live cervical ectopic

Case contributed by Dr Alexandra Stanislavsky


Bleeding per vagina, elevated beta hCG. No previous ultrasound.

Patient Data

Age: 30 years
Gender: Female

The endometrial cavity is empty.  There is however a gestational sac located within the cervix, which contains a yolk sac and a fetal pole with cardiac activity. No perigestational haemorrhage is seen.

Case Discussion

The finding of a gestational sac within the endocervix has two differentials:  a cervical ectopic, and an inevitable miscarriage.  

On follow-up in this case, products of conception were passed soon after this ultrasound, and a subsequent scan showed an empty uterus and endocervix, confirming the diagnosis of inevitable miscarriage.

Nonetheless, this appearance should have a high index of suspicion for a cervical ectopic, which is a potentially more serious diagnosis, with risk of haemorrhage.

Notably the presence of cardiac activity in an endocervical miscarriage is an unusual feature in this case. 

PlayAdd to Share

Case information

rID: 29009
Case created: 26th Apr 2014
Last edited: 12th Feb 2018
System: Obstetrics
Inclusion in quiz mode: Included

Updating… Please wait.

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.