Treatment of early cervical pregnancy with cerclage, carboprost, curettage, and balloon tamponade.
BACKGROUND
Cervical pregnancy, an uncommon variety of ectopic gestation is associated with high morbidity and adverse consequences for future fertility. Currently there are no specific recommendations for the best treatment of this entity.


METHODS
A 35-year-old nullipara presented with 8 weeks of amenorrhea and painless brown discharge. The patient was diagnosed with cervical pregnancy with embryonic cardiac activity. A conservative surgical treatment under general anesthesia involved intracervical infiltration of carboprost, cerclage, suction curettage of cervix, and Foley balloon tamponade was performed. The Foley was removed on day 2 and the cerclage on day 7.


CONCLUSIONS
Early cervical pregnancy was treated with combined cervical cerclage, intracervical infiltration of carboprost, curettage, and balloon tamponade. Severe hemorrhage during suction curettage and the adverse effects and complications of systemic methotrexate treatment were avoided.
De La Vega
Guillermo A
GA
Department of Obstetrics and Gynecology, Pennsylvania Hospital, University of Pennsylvania, Philadelphia, Pennsylvania 19107-6192, USA. guillermodelavega@comcast.net
Avery
Caudrean
C
Nemiroff
Richard
R
Marchiano
Dominic
D
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000328:Adult; D002260:Carboprost / Q000008:administration & dosage; D002404:Catheterization; D023802:Cerclage, Cervical; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004107:Dilatation and Curettage; D005260:Female; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011271:Pregnancy, Ectopic / Q000175:diagnosis* / Q000628:therapy*; D019522:Vaginal Discharge
D000020:Abortifacient Agents, Nonsteroidal; D002260:Carboprost