Cervical ectopic pregnancy successfully treated with local methotrexate injection.
OBJECTIVE
To report a case where intra-amniotic injection of methotrexate (MTX) was used to terminate a cervical ectopic pregnancy that was resistant to IM MTX treatment.


METHODS
Case report.


METHODS
A 31-year-old woman, gravida 2, para 1, presented with painless vaginal bleeding. An early cervical pregnancy was diagnosed by transvaginal ultrasound.


METHODS
Intramuscular MTX therapy was started without success, and an intra-amniotic injection of MTX under ultrasonographic guidance was performed.


METHODS
Pregnancy termination.


RESULTS
Pregnancy termination was successful, without complications or side effects.


CONCLUSIONS
Local installation of MTX appears to be an effective and safe method; however, choice depends on gestational age, desire to preserve fertility, and, most of all, hemodynamic stability.
Cerveira
Isabel
I
Departments of Obstetrics, Hospital de São Teotónio, Viseu, Portugal. isabelcerveira@hotmail.com
Costa
Cristina
C
Santos
Fernando
F
Santos
Lourdes
L
Cabral
Fernando
F
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000028:Abortion, Induced; D000328:Adult; D000653:Amniotic Fluid; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008727:Methotrexate / Q000008:administration & dosage*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging / Q000188:drug therapy*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D016216:Ultrasonography, Prenatal
D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate