Mesogitis Spiros, Pilalis Athanasios, Daskalakis George, Papantoniou Nikolaos, Antsaklis Aris
1st Department of Obstetrics and Gynecology, University of Athens, Alexandra Hospital, Greece.
BJOG. 2005 Apr;112(4):409-11. doi: 10.1111/j.1471-0528.2004.00447.x.
To evaluate conservative management of early viable cervical pregnancy.
Prospective study.
A tertiary teaching hospital.
All cases of cervical pregnancies with fetal cardiac activity presenting to our hospital over six years.
All cases were managed with trans-abdominal intra-amniotic injection of 25 mg of methotrexate under ultrasound guidance. Follow up sonographic examinations and serum beta-hCG measurements were performed every three days. Cervical curettage was performed after two follow up ultrasound examinations had shown a dead fetus and a regressing gestational sac as well as declining beta-hCG levels. Patients were managed as outpatients.
Successful management and need for hospitalisation.
Nine cases were encountered. Two required a second injection of methotrexate for persistent fetal cardiac activity and serum beta-hCG rise in the follow up examination. We did not observe any side effects and no patient required admission to the hospital.
Intra-amniotic methotrexate injection and subsequent cervical curettage after one week is a successful alternative for the management of cervical pregnancies.
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