Pretzsch G, Einenkel J, Baier D, Horn L C, Alexander H
Universitäts-Frauenklinik Leipzig.
Zentralbl Gynakol. 1997;119(1):25-34.
We report on a 22 years old patient with an intact cervical pregnancy located around the cervical isthmus in the 9th week of gestation. Because of the patients strong desire to maintain the reproductive capability, we performed a transvaginal amniotic sac puncture with local application of methotrexate. Later on we applied a systemic methotrexate therapy because of persistent high serum beta-hCG values. Five weeks later the patients developed heavy vaginal bleeding despite low beta-hCG levels so we are obliged to perform vaginal hysterectomy. Actual aspects about the etiology and diagnosis of this rare disease as well as about different opinions regarding conservative, fertility maintaining therapies are discussed.
我们报告了一名22岁的患者,其宫颈妊娠完整,位于妊娠第9周的宫颈峡部周围。由于患者强烈希望保留生殖能力,我们进行了经阴道羊膜囊穿刺,并局部应用甲氨蝶呤。后来,由于血清β-hCG值持续居高不下,我们进行了全身甲氨蝶呤治疗。五周后,尽管β-hCG水平较低,但患者仍出现大量阴道出血,因此我们不得不进行阴道子宫切除术。本文讨论了这种罕见疾病的病因、诊断的实际情况,以及关于保守的、保留生育能力治疗的不同观点。