Chelli Dalenda, Dimassi Kaouther, Bouaziz Mouna, Manai Soumaya, Béchir Zouaoui, Sfar Ezzeddine, Chelli Héla, Badis Chennoufi Mohamed
Service A du centre de maternité et de néonatologie Tunis.
Tunis Med. 2009 Sep;87(9):616-20.
Cervical pregnancy is the rarest of ectopic pregnancy. The classical treatment remains hysterectomy, in particular when diagnosis is made late. The possibilities of more and more premature diagnoses, sometimes before any clinical expression, let suspect the possibility of conservative treatments. We report two cases of medical treatment for early diagnosed cervical pregnancies.
Through a review of the literature, we resume diagnostic criteria and various therapeutic possibilities.
The two cases were diagnosed in the first trimester. The treatment consisted in intramuscular administration of methotrexate. The first patient had ultrasound-Guided feticide before the administration of methotrexate.
Actually, vaginal ultrasound allows early diagnosis of cervical pregnancies, even before the beginning of vaginal bleeding. This advancement allowed conservative treatment. In this situation, current reference is the methotrexate to which can be associated an intracardiac potassium chloride injection in case of embryo positive heart activity.
宫颈妊娠是最罕见的异位妊娠类型。经典的治疗方法仍然是子宫切除术，尤其是在诊断较晚时。越来越多的早期诊断可能性，有时甚至在出现任何临床表现之前，让人怀疑保守治疗的可能性。我们报告两例早期诊断的宫颈妊娠的药物治疗病例。
通过文献回顾，我们总结诊断标准和各种治疗可能性。
这两例均在孕早期被诊断。治疗方法为肌肉注射甲氨蝶呤。第一例患者在注射甲氨蝶呤前进行了超声引导下的胎儿减灭术。
实际上，经阴道超声能够早期诊断宫颈妊娠，甚至在阴道出血开始之前。这一进展使得保守治疗成为可能。在这种情况下，目前的参考药物是甲氨蝶呤，若胚胎有心脏活动，可联合心内注射氯化钾。
