title: Cervical ectopic pregnancy successfully treated with local methotrexate injection.
abstract: 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.
authors.affiliation: Departments of Obstetrics, Hospital de São Teotónio, Viseu, Portugal. isabelcerveira@hotmail.com
authors.forename: Isabel
authors.initials: I
authors.lastname: Cerveira
authors.forename: Cristina
authors.initials: C
authors.lastname: Costa
authors.forename: Fernando
authors.initials: F
authors.lastname: Santos
authors.forename: Lourdes
authors.initials: L
authors.lastname: Santos
authors.forename: Fernando
authors.initials: F
authors.lastname: Cabral
mesh_terms: 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
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate