Hysteroscopic Removal of Cervical Ectopic Pregnancy Following Failed Intramuscular/Intra-Sac Methotrexate: A Case Report.
Background:Cervical pregnancy is a diagnosis associated with significant morbidity, specifically life-threatening hemorrhage that potentially requires hysterectomy to prevent maternal death. Conservative and fertility-sparing management strategies are poorly described in the literature, and there is no clear standard of care.Case:The patient was a 34-year-old gravida 1, para 0 who had conceived spontaneously after laparoscopic treatment of endometriosis, and was found to have cervical pregnancy. She received both intramuscular and intra-sac methotrexate, with no resolution of the ectopic pregnancy. The pregnancy was removed hysteroscopically.Results:Subsequently, the patient was able to achieve a normal clinical pregnancy with ovulation induction/intrauterine insemination. This pregnancy was carried to term.Conclusions:Although cervical pregnancy is particularly hazardous and potentially fatal, conservative/fertility-sparing management of these pregnancies can be successful. (J GYNECOL SURG 28:369).
Department of Obstetrics and Gynecology, New York Presbyterian Hospital - Weill Cornell Medical Center , New York, NY.
Jason D
JD
Kofinas
Department of Obstetrics and Gynecology, New York Presbyterian Hospital - Weill Cornell Medical Center , New York, NY.
Stephanie E
SE
Purisch
Department of Obstetrics and Gynecology, New York Presbyterian Hospital - Weill Cornell Medical Center , New York, NY.
Justin S
JS
Brandt
Department of Obstetrics and Gynecology, New York Methodist Hospital , Brooklyn, NY.
Melissa
M
Montes