Ozcivit Ipek Betul, Cepni Ismail, Hamzaoglu Kubra, Erenel Hakan, Madazlı Rıza
Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty, Istanbul University Cerrahpasa, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty, Istanbul University Cerrahpasa, Istanbul, Turkey.
Int J Surg Case Rep. 2020;67:215-218. doi: 10.1016/j.ijscr.2020.01.020. Epub 2020 Jan 27.
The ultimate treatment approach for cervical ectopic pregnancy remains controversial. Gestational age, serum β-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.
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.
The case presented here is exceptional because even though the advanced gestational age, presence of fetal cardiac activity and high serum β-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.
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 β-hCG levels.
宫颈异位妊娠的最终治疗方法仍存在争议。孕周、血清β-人绒毛膜促性腺激素（β-hCG）水平、胎儿心搏情况以及患者对保留生育能力的诉求是每个病例选择治疗方法时的主要挑战。药物治疗对于晚期诊断病例以及早期病例而言可能都是一种不错的选择。
在本病例报告中，我们旨在呈现一例孕10又4/7周的宫颈异位妊娠病例，该病例通过经阴道超声引导下局部及全身注射甲氨蝶呤成功治愈。
此处呈现的病例较为特殊，因为尽管孕周较大、存在胎儿心搏且血清β-hCG值较高，但流产仍成功发生。无需进一步手术干预的保守治疗足以实现完全康复并保留生殖能力。
总之，对于孕周较大、存在胎儿心搏且血清β-hCG水平较高的病例，经阴道超声引导下局部及全身注射甲氨蝶呤可能会成功施行。
