Management of early viable cervical pregnancy.
OBJECTIVE
To evaluate conservative management of early viable cervical pregnancy.


METHODS
Prospective study.


METHODS
A tertiary teaching hospital.


METHODS
All cases of cervical pregnancies with fetal cardiac activity presenting to our hospital over six years.


METHODS
All cases were managed with trans-abdominal intra-amniotic injection of 25 mg of methotrexate under ultrasound guidance. Follow up sonographic examinations and serum beta-hCG measurements were performed every three days. Cervical curettage was performed after two follow up ultrasound examinations had shown a dead fetus and a regressing gestational sac as well as declining beta-hCG levels. Patients were managed as outpatients.


METHODS
Successful management and need for hospitalisation.


RESULTS
Nine cases were encountered. Two required a second injection of methotrexate for persistent fetal cardiac activity and serum beta-hCG rise in the follow up examination. We did not observe any side effects and no patient required admission to the hospital.


CONCLUSIONS
Intra-amniotic methotrexate injection and subsequent cervical curettage after one week is a successful alternative for the management of cervical pregnancies.
Mesogitis
Spiros
S
1st Department of Obstetrics and Gynecology, University of Athens, Alexandra Hospital, Greece.
Pilalis
Athanasios
A
Daskalakis
George
G
Papantoniou
Nikolaos
N
Antsaklis
Aris
A
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000032:Abortion, Therapeutic / Q000379:methods*; D000328:Adult; D000650:Amnion; D003475:Curettage / Q000379:methods*; D005260:Female; D006801:Humans; D007267:Injections; D008727:Methotrexate / Q000008:administration & dosage*; D006473:Postpartum Hemorrhage / Q000517:prevention & control; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000628:therapy*; D011446:Prospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods
D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate