Treatment of cervical pregnancy with methotrexate.
OBJECTIVE
To review our experience with early ultrasonographic diagnosis and fertility-preserving complete medical treatment of cervical pregnancy.


METHODS
From January 1989 to December 1994, 11 cases of cervical pregnancy diagnosed by ultrasonography and treated with methotrexate were evaluated. Patients were treated as follows: systemic administration of methotrexate with leucovorin rescue, a single dose of 50 mg of methotrexate intramuscular injection, or transvaginal ultrasonographically-guided intra-amniotic instillation of 50 mg of methotrexate.


RESULTS
The mean age of these patients was 33.3 +/- 6.2 years and gestational age at diagnosis ranged from 32 to 73 days. The maximal serum beta-hCG measured was 135,000 mIU/ml, and the time required for return to normal levels ranged from 20 to 157 days. The ectopic gestation was successfully ablated in all cases, and none required hysterectomy.


CONCLUSIONS
If a cervical pregnancy is present and diagnosed early, methotrexate treatment, administered either systemically or locally, is effective as the definitive therapy.
Hung
T H
TH
Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
Jeng
C J
CJ
Yang
Y C
YC
Wang
K G
KG
Lan
C C
CC
D000328:Adult; D002584:Cervix Uteri; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005260:Female; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000627:therapeutic use; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging / Q000188:drug therapy*; D012189:Retrospective Studies; D014463:Ultrasonography
D018997:Chorionic Gonadotropin, beta Subunit, Human; D002955:Leucovorin; D008727:Methotrexate