title: Management of early viable cervical pregnancy.
abstract: 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.
authors.affiliation: 1st Department of Obstetrics and Gynecology, University of Athens, Alexandra Hospital, Greece.
authors.forename: Spiros
authors.initials: S
authors.lastname: Mesogitis
authors.forename: Athanasios
authors.initials: A
authors.lastname: Pilalis
authors.forename: George
authors.initials: G
authors.lastname: Daskalakis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papantoniou
authors.forename: Aris
authors.initials: A
authors.lastname: Antsaklis
mesh_terms: 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
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate