Combined intrauterine and twin cervical pregnancy managed by a new conservative modality.
OBJECTIVE
To describe a rare case of a heterotopic pregnancy with two gestational sacs in the cervix and one in the uterine cavity.


METHODS
Case report.


METHODS
Tertiary university hospital.


METHODS
A 45-year-old woman was diagnosed with a triplet gestation 7 weeks following IVF treatment for primary infertility of 5 years' duration. Transvaginal ultrasound scan revealed three gestational sacs: one sac inside the uterine cavity containing a live fetus, and two sacs in the uterine cervix, one containing a live fetus and a second empty sac.


METHODS
Pregnancy termination was performed by selective intraarterial catheterization of the uterine artery, intraarterial administration of methotrexate, and uterine artery embolization with Gelfoam.


METHODS
Intra- or postprocedural complications and fertility preservation.


RESULTS
The pregnancy termination was successfully performed without intra- or postprocedural complications, with preservation of the patient's fertility.


CONCLUSIONS
Intraarterial methotrexate with uterine vessel embolization is an effective conservative approach to heterotopic cervical pregnancy.
Nitke
Shmuel
S
The Helen Schneider Comprehensive Women's Health Center, Rabin Medical Center, Petach Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Horowitz
Eran
E
Farhi
Jacob
J
Krissi
Haim
H
Shalev
Josef
J
D000028:Abortion, Induced / Q000379:methods; D002584:Cervix Uteri; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000628:therapy*; D011272:Pregnancy, Multiple; D014599:Uterus / Q000098:blood supply