title: Diagnostic and therapeutic dilemmas of cervical ectopic pregnancy.
abstract: OBJECTIVE
  Cervical pregnancy is a rare variety of ectopic pregnancy. The etiology is obscure. Its diagnosis may be difficult, and its management has enormously changed during the last 10 years. Unfortunately, the most effective, fertility-sparing treatment is still unclear until now.
  
  
  OBJECTIVE
  The aim of this study was to explore the safety and efficacy of different treatment modalities of cervical pregnancy.
  
  
  METHODS
  A comprehensive systematic review of the literature was performed using the electronic databases MEDLINE and PubMed, using key words cervical, ectopic, and pregnancy, between January 2005 and June 2013. We included all case reports and case series reporting on cervical ectopic pregnancy.
  
  
  RESULTS
  A total of 252 cases of cervical ectopic pregnancy were analyzed. Eighty-eight cases (34.9%) had medical treatment, 69 cases (27.5%) had surgical treatment, and 95 cases (37.6%) had combined medical and surgical treatment. Various conservative treatment regimens have been introduced to preserve fertility in young women, with methotrexate being one of the most widely used and effective drugs.
  
  
  CONCLUSIONS
  A high index of suspicion, combined with meticulous review of clinical and radiological findings, is essential to make an accurate diagnosis of cervical pregnancy. The success of conservative treatment depends mainly on early diagnosis. Such cases would be best managed at specialist tertiary referral centers and preferably, where available, Early Pregnancy Assessment Units, whether medical, surgical, or combined treatment modalities were attempted.
authors.affiliation: Clinical Lecturer, Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt.
authors.forename: Mohamed Maged
authors.initials: MM
authors.lastname: Hosni
authors.affiliation: Senior Lecturer, Department of Obstetrics and Gynecology, Kelaniya University Hospitals, Kelaniya, Sri Lanka.
authors.forename: Rasika P
authors.initials: RP
authors.lastname: Herath
authors.affiliation: Consultant, Department of Obstetrics and Gynecology, James Paget University Hospitals, Great Yarmouth, UK.
authors.forename: Rashid
authors.initials: R
authors.lastname: Mumtaz
mesh_terms: D002584:Cervix Uteri; D004107:Dilatation and Curettage; D004621:Embolization, Therapeutic; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D007044:Hysterectomy; D008727:Methotrexate / Q000627:therapeutic use; D019384:Nucleic Acid Synthesis Inhibitors / Q000627:therapeutic use; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis* / Q000628:therapy*
chemical_list: D019384:Nucleic Acid Synthesis Inhibitors; D008727:Methotrexate