title: Management of cervical ectopic pregnancy after unsuccesful methotrexate treatment.
abstract: BACKGROUND
  Cervical pregnancy is rare and dangerous form of ectopic pregnancy which can be treated surgically or conservatively. Methotrexate is reasonable conservative option with high efficiency and acceptable level of side effects. Aim of this paper is to present possible treatment option in case of methotrexate failure, still keeping the postulates of minimal invasive surgery.
  
  
  METHODS
  We describe a case of cervical ectopic pregnancy in nulliparous female that was unsuccessfully treated with single dose, local, ultrasound guided intraamniotic methotrexate. Due to vaginal bleeding caused by remaining products of conception a hysteroscopic resection was performed.
  
  
  CONCLUSIONS
  Despite the problems that can occur in methotrexate treatment, it is still by far, cheapest and most effective treatment of cervical pregnancies. If necessary, procedure can be combined with other minimal invasive surgical procedures leading to satisfactory results. Hysteroscopic resection has enabled us to remove the product of conception from cervix making the minimal damage to the local tissue, thus preserving fertility.
authors: Cathedra for Gynaecology and Obstetrics, JJ. Strossmeyer University School of Medicine Osijek, Croatia.
authors: Siniša
authors: S
authors: Sijanović
authors: Cathedra for Gynaecology and Obstetrics, JJ. Strossmeyer University School of Medicine Osijek, Croatia.
authors: Domagoj
authors: D
authors: Vidosavljević
authors: Cathedra for Gynaecology and Obstetrics, JJ. Strossmeyer University School of Medicine Osijek, Croatia.
authors: Zlatko
authors: Z
authors: Topolovec
authors: Cathedra for Gynaecology and Obstetrics, JJ. Strossmeyer University School of Medicine Osijek, Croatia.
authors: Andrea
authors: A
authors: Milostić-Srb
authors: Institute for pathology and forensic medicine, KBC Osijek, Osijek, Croatia.
authors: Milanka
authors: M
authors: Mrčela
keywords: Cervical pregnancy; Ectopic pregnancy; Hysteroscopy; Methotrexate