Successful Management of Early Cervical Ectopic Pregnancy with Single Dose Methotrexate (original) (raw)
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Management of cervical ectopic pregnancy after unsuccesful methotrexate treatment
Iranian Journal of Reproductive Medicine, 2014
Background: Cervical pregnancy is rare and dangerous form of ectopic pregnancy which can be treated surgically or conservatively. Methotrexate is reasonable conservative option with high efficiency and acceptable level of side effects. Aim of this paper is to present possible treatment option in case of methotrexate failure, still keeping the postulates of minimal invasive surgery. Case: We describe a case of cervical ectopic pregnancy in nulliparous female that was unsuccessfully treated with single dose, local, ultrasound guided intraamniotic methotrexate. Due to vaginal bleeding caused by remaining products of conception a hysteroscopic resection was performed. Conclusion: Despite the problems that can occur in methotrexate treatment, it is still by far, cheapest and most effective treatment of cervical pregnancies. If necessary, procedure can be combined with other minimal invasive surgical procedures leading to satisfactory results. Hysteroscopic resection has enabled us to rem...
Ultrasonographic appearance of cervical pregnancy following successful treatment with methotrexate
Ultrasound in Obstetrics and Gynecology, 2006
We report a case of cervical ectopic pregnancy successfully treated with systemic methotrexate. Conservative management with single-dose methotrexate was undertaken, but owing to the failure of human chorionic gonadotropin (hCG) levels to fall by 15% by day 7 and the persistence of fetal cardiac activity, two further doses of methotrexate were required. The patient's hCG levels were monitored, and repeat transvaginal ultrasonography was performed until complete resolution of the pregnancy by spontaneous miscarriage. We describe the ultrasonographic findings, which showed that the sac size increased despite treatment.
International Journal of Surgery Case Reports, 2020
INTRODUCTION: The ultimate treatment approach for cervical ectopic pregnancy remains controversial. Gestational age, serum -hCG levels, fetal cardiac activity presence and the patient's claim for fertility preservation are the major challenges for method of choice in each individual case. Medical treatment may be a favorable option for the treatment of late diagnosed cases, as well as the early ones. PRESENTATION OF CASE: In this case report, we aim to present a case of 10 4/7 weeks of cervical ectopic pregnancy successfully treated with transvaginal ultrasound-guided local and systemic methotrexate injection. DISCUSSION: The case presented here is exceptional because even though the advanced gestational age, presence of fetal cardiac activity and high serum -hCG values, the abortion has occurred successfully. Conservative treatment without any need of further surgical intervention was sufficient for full recovery with the preservation of reproductive capacity. CONCLUSION: In conclusion, transvaginal ultrasound guided local and systemic methotrexate injection may be performed successfully for the cases of advanced gestational age with fetal cardiac activity and high serum -hCG levels.
Cervical ectopic pregnancy successfully treated with local methotrexate injection
Fertility and Sterility, 2008
Objective: To report a case where intra-amniotic injection of methotrexate (MTX) was used to terminate a cervical ectopic pregnancy that was resistant to IM MTX treatment. Design: Case report. Patient(s): A 31-year-old woman, gravida 2, para 1, presented with painless vaginal bleeding. An early cervical pregnancy was diagnosed by transvaginal ultrasound. Intervention(s): Intramuscular MTX therapy was started without success, and an intra-amniotic injection of MTX under ultrasonographic guidance was performed. Main Outcome Measure(s): Pregnancy termination. Result(s): Pregnancy termination was successful, without complications or side effects. Conclusion(s): Local installation of MTX appears to be an effective and safe method; however, choice depends on gestational age, desire to preserve fertility, and, most of all, hemodynamic stability. (Fertil Steril Ò 2008;90:2005.e7-e10.
Fertility and Sterility, 2004
Objective: To present a case of cervical ectopic pregnancy successfully treated with ultrasound-guided aspiration and single-dose methotrexate administered systemically. Design: Case report. Setting: University hospital. Patient(s): A 27-year-old nulliparous woman with a cervical ectopic pregnancy. Intervention(s): Transvaginal ultrasound-guided aspiration of the cervical ectopic pregnancy followed by single-dose methotrexate administered systemically. Main Outcome Measure(s): Recovery of the patient, successful conservative treatment of the cervical ectopic pregnancy, with preservation of the uterus. Result(s): The cervical ectopic pregnancy was successfully aborted, and the reproductive capability of the patient was preserved. Conclusion(s): Transvaginal ultrasound-guided aspiration in combination with single-dose methotrexate administered systemically can be safely used to treat cervical ectopic pregnancies.
Conservative management of cervical ectopic pregnancy: systemic methotrexate followed by curettage
Archives of Gynecology and Obstetrics, 2013
Introduction Cervical ectopic pregnancy is among the rarest clinical conditions happening in women of reproductive age. Yet its management can cause a high rate of morbidity. Therefore, conservative treatment of this condition is a matter of debate. Material and methods Hereby we present two cases of cervical ectopic pregnancies that were managed successfully with a conservative approach. Conclusion Cervical ectopic pregnancy can be managed successfully with systemic Metotroxsate followed by curettage.
2000
Cervical ectopic pregnancy is the implantation of a pregnancy in the endocervical canal. Diagnosis and treatment of cervical ectopic pregnancy has changed dramatically in the last 15 years. Before 1980, the diagnosis commonly was made when dilation and curettage for presumed incomplete abortion resulted in unexpected hemorrhage. Emergency hysterectomy usually ensued. Cervical ectopic pregnancy is now commonly diagnosed on a first-trimester ultrasound examination. The family physician practicing obstetrics must consider the diagnosis of cervical ectopic pregnancy in women with first-trimester vaginal bleeding or pelvic pain to permit early diagnosis and fertility-saving treatment. A case report of diagnosis and successful medical management of a cervical ectopic pregnancy is presented. The literature on the epidemiology, causes, diagnosis, and treatment of cervical ectopic pregnancy is reviewed.
Single Dose Methotrexate In Treatment Of Ectopic Pregnancy: Review Of 32 Cases
Medical Journal of Trakya University, 2009
Objective: To evaluate the efficacy of single dose intramuscular methotrexate in the treatment of ectopic pregnancy. Material and Methods: 32 patients who matched the inclusion criteria were enrolled. Success of treatment was defined as a resolution of ectopic pregnancy without performing surgical intervention. The cases in whom the treatment was successful and those that were not were compared for β-hCG values and clinical features. Results: β-hCG at diagnosis averaged 1293.9 mIU/ml. Of the 32 patients who received methotrexate, 26 were successfully treated. 23 patients (71.8%) received a single dose of methotrexate, 3 patients (9.3%) received an additional dose of methotrexate, 6 patients (18.7%) who had failed methotrexate required surgery for cure. The success rate of single-dose methotrexate was 79.3%. Conclusion: Our study shows that single dose systemic methotrexate treatment can be used as an option in unruptured pregnancies.