Dotters D J, Katz V L, Kuller J A, McCoy M C
Department of OB/GYN, UNC School of Medicine, Chapel Hill 27599-7570, USA.
Eur J Obstet Gynecol Reprod Biol. 1995 Jun;60(2):187-9. doi: 10.1016/0028-2243(95)02039-u.
Until very recently cervical pregnancies have been treated with surgery, usually hysterectomy. The development of endovaginal ultrasound, which allows early diagnosis, and methotrexate chemotherapy have opened up new therapeutic options. A 45-year-old multigravida presented at 8 weeks' gestation with vaginal bleeding. Endovaginal ultrasound demonstrated a cervical pregnancy with a fetal pole, 1.2 x 1.4 cm sac, no cardiac pulsations, and an empty uterus. After discussion with the patient, single low dose methotrexate 1.5 mg/m2 was given intramuscularly. The patient's hCG titre was 5882 IU-(Third International Standard). Over a 5-week period the hCG titres fell, and the gestational sac disappeared. The patient experienced intermittent vaginal bleeding and cramping but was managed as an outpatient. Single low dose methotrexate may be a successful management option in selected cases of cervical pregnancy.
直到最近，宫颈妊娠的治疗方法一直是手术，通常是子宫切除术。经阴道超声的发展使得早期诊断成为可能，而甲氨蝶呤化疗则开辟了新的治疗选择。一名45岁的经产妇在妊娠8周时出现阴道出血。经阴道超声显示为宫颈妊娠，有一个胎芽，孕囊大小为1.2×1.4厘米，无心跳，子宫内为空。与患者讨论后，给予单次低剂量甲氨蝶呤1.5毫克/平方米肌肉注射。患者的人绒毛膜促性腺激素（hCG）水平为5882国际单位（第三国际标准）。在5周的时间里，hCG水平下降，孕囊消失。患者经历了间歇性阴道出血和腹痛，但作为门诊患者进行处理。单次低剂量甲氨蝶呤在某些宫颈妊娠病例中可能是一种成功的治疗选择。
