title: Management of cervical pregnancy: risk factors for failed systemic methotrexate.
abstract: Cervical pregnancy is a rare obstetrical complication. Conservative management with systemic methotrexate has been reported to be successful, obviating the need for surgical treatment which entails a risk for hysterectomy. We report the case of a nulliparous patient with a cervical pregnancy diagnosed at 9 weeks' gestation who after systemic methotrexate treatment necessitated conservative surgical management. This patient highlights the utility of identified risk factors for failure of methotrexate treatment.
authors.affiliation: High Risk Pregnancy Unit, Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, Ecuador.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Hidalgo
authors.forename: Jaime
authors.initials: J
authors.lastname: Peñafiel
authors.forename: Peter A
authors.initials: PA
authors.lastname: Chedraui
mesh_terms: D000019:Abortifacient Agents / Q000008:administration & dosage*; D000328:Adult; D002584:Cervix Uteri; D004107:Dilatation and Curettage; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008727:Methotrexate / Q000008:administration & dosage*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D012307:Risk Factors; D017211:Treatment Failure; D016216:Ultrasonography, Prenatal
chemical_list: D000019:Abortifacient Agents; D008727:Methotrexate