title: Conservative management of cervical pregnancy with embryonic heart activity by ultrasound-guided local injection: an eight case series.
abstract: OBJECTIVE
  To evaluate the efficacy of conservative management of cervical pregnancy with embryonic heart activity by ultrasound-guided local injection.
  
  
  METHODS
  Retrospective case series at University tertiary care Hospital. Eight patients diagnosed with cervical pregnancy with embryonic heart activity managed conservatively. The intervention was ultrasound-guided local injection of methotrexate (1 mg/kg) and potassium chloride (2 meq/mL). Measurements were occurrence of morbidity, necessity for further intervention, the initial titers of beta-hCG, interval of time in which the levels of beta-hCG became negative, period for regression of cervical pregnancy at ultrasound and future pregnancy.
  
  
  RESULTS
  All patients were treated successfully. The initial levels of beta-hCG ranged from 3013 to 71199 mUI/mL. One case evaluated with infection. There was no need for additional intervention in our series study. The interval of time for the levels of beta-hCG becomes negative range from 2 to 12 weeks. The period for the regression of the cervical pregnancy at ultrasound range from 3 to 14 weeks. In two cases intrauterine pregnancies occurred after the treatment.
  
  
  CONCLUSIONS
  Conservative management of cervical pregnancy with embryonic heart activity by ultrasound-guided injection is an effective treatment avoiding the need of further intervention.
authors.affiliation: Department of Obstetrics, São Paulo Federal University (UNIFESP) , São Paulo - SP , Brazil.
authors.forename: Julio Elito
authors.initials: JE
authors.lastname: Júnior
authors.forename: Rubens Bermudes
authors.initials: RB
authors.lastname: Musiello
authors.forename: Edward
authors.initials: E
authors.lastname: Araujo Júnior
authors.forename: Eduardo
authors.initials: E
authors.lastname: Souza
authors.forename: Jair Luiz
authors.initials: JL
authors.lastname: Fava
authors.forename: Eduardo Almeida
authors.initials: EA
authors.lastname: Guerzet
authors.forename: Luiz
authors.initials: L
authors.lastname: Camano
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000328:Adult; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage*; D011189:Potassium Chloride / Q000008:administration & dosage*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional; D002577:Uterine Cervical Diseases / Q000188:drug therapy*
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D011189:Potassium Chloride; D008727:Methotrexate
keywords: Cervical pregnancy; conservative management; methotrexate; potassium chloride injection; ultrasound