[Seven-weeks cervical pregnancy treated successfully with methotrexate - a case report].
The paper presents the case of a 7-weeks-cervical pregnancy treated successfully with methotrexate. A 16 years-old nullipara girl was admitted to the hospital, because of moderate bleeding from the vagina and mild lower abdominal pain. The last menstruation was 56 days before admission. The vaginal part of the cervix was bluish and thickened. 0 x 03B2-hCG concentration in blood serum was 2.65 IU/ml. In the endovaginal USG the pregnancy follicle was not seen in the uterine cavity, but the uterine cervix was expanded in the middle part by an echo negative follicle 10.5 mm in diameter. The foetal heart beat was not visible. Because of the patient's young age, 50mg of methotrexate (MTX) was applied intravenously. 0 x 03B2-hCG concentration decreased to 1.18 IU/ml on 4th day, but the follicle halo in USG was still visible so an additional dose of 25 mg methotrexate i.v. was applied. 0x03B2-hCG fell to 0,0485 IU/ml on the 10th day and USG showed, tissues of differentiated echogenicity and faint contour of the follicle in the cervical canal. Curettage of the cervix and uterus was made without any complications. Subsequent examinations showed decreasing concentration of 0 x 03B2-hCG. The patient, in good condition, was discharged from the hospital after five days. Methotrexate in treatment of cervical pregnancy is safe and allows to preserve the uterus and fertility in young nullipara adolescent women with cervical pregnancy. Few reports in the literature describe the use of methotrexate in ectopic pregnancy in teenagers, but no reported cases of cervical pregnancy treated with methotrexate have been found.
Olejek
Anita
A
Katedra i Klinika Ginekologii, Połoznictwa i Ginekologii Onkologicznej, ul. Batorego15, 41-902 Bytom.
Horak
Stanisław
S
Zamłyński
Jacek
J
Bodzek
Piotr
P
Stołtny
Piotr
P
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000028:Abortion, Induced / Q000379:methods*; D000293:Adolescent; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D006063:Chorionic Gonadotropin / Q000097:blood; D004107:Dilatation and Curettage; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008727:Methotrexate / Q000008:administration & dosage*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011271:Pregnancy, Ectopic / Q000097:blood / Q000000981:diagnostic imaging; D016216:Ultrasonography, Prenatal
D000020:Abortifacient Agents, Nonsteroidal; D006063:Chorionic Gonadotropin; D008727:Methotrexate