Cervical Ectopic and Cesarean Scar Pregnancies: Navigating the Differential of an Abnormal Lower Uterine Pregnancy

, such as the ovary, abdomen, or cervix. Fewer than 10% of all ectopic pregnancies occur outside the fallopian tube, but these ectopic pregnancies contribute more significantly to A 30-year-old gravida 3 para 2002 woman at 5 weeks estimated gestational age by her last menstrual period presents to the emergency department with mild cramping and vaginal bleeding. Examination demonstrates a small amount of dark red bleeding and mild, diffuse tenderness to palpa-tion over bilateral lower abdominal quadrants. Her vital signs are normal. Laboratory workup is unremarkable, consistent with pregnancy with a beta-human chorionic gonadotropin ( β hCG) value of 3700 IU/L. She is Rh positive. Ultrasound shows a yolk sac consistent with gestational age in the lower portion of the uterus, near the cervix (Figure 1). Most obstetrician-gynecologists have cared for