title: Conservative management of cervical pregnancy with intramuscular administration of methotrexate and KCl injection: Case report and review of the literature.
abstract: We report the case of a cervical pregnancy successfully treated with intramuscular injection of methotrexate (MTX) and intramniotic administration of potassium chloride. A 41-year-old woman was admitted to our Department with the suspicion of ectopic pregnancy. Transvaginal ultrasound revealed empty endometrial cavity, gestational sac within the cervical canal and embryonic echo measuring crown rump length 1.5 mm. Serum beta human chorionic gonadotropine (β-HCG) was measured 28590 IU/L. No cardiac activity was detected. The diagnosis of a cervical pregnancy was made. Patient was treated with intramuscular administration of methotrexate (50 mg/m(2)) in combination with ultrasound-guided intramniotic injection of KCl (2 meq/mL). Gradual decrease of β-HCG levels as well as ultrasound observation of collapsed gestational sac was observed. No curettage was necessitated. Patient was discharged on day 10(th) and was set in follow-up on a weekly basis. β-HCG values were measured < 10 IU/L on 56(th) day after MTX administration. Intramuscular administration of MTX may be effective in treatment of cervical pregnancy without additional interventional measures.
authors.affiliation: Stamatios Petousis, Chrysoula Margioula-Siarkou, Ioannis Kalogiannidis, George Karavas, Vasileios Palapelas, Nikolaos Prapas, David Rousso, 3 Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, 56224 Evosmos, Thessaloniki, Greece.
authors.forename: Stamatios
authors.initials: S
authors.lastname: Petousis
authors.affiliation: Stamatios Petousis, Chrysoula Margioula-Siarkou, Ioannis Kalogiannidis, George Karavas, Vasileios Palapelas, Nikolaos Prapas, David Rousso, 3 Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, 56224 Evosmos, Thessaloniki, Greece.
authors.forename: Chrysoula
authors.initials: C
authors.lastname: Margioula-Siarkou
authors.affiliation: Stamatios Petousis, Chrysoula Margioula-Siarkou, Ioannis Kalogiannidis, George Karavas, Vasileios Palapelas, Nikolaos Prapas, David Rousso, 3 Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, 56224 Evosmos, Thessaloniki, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kalogiannidis
authors.affiliation: Stamatios Petousis, Chrysoula Margioula-Siarkou, Ioannis Kalogiannidis, George Karavas, Vasileios Palapelas, Nikolaos Prapas, David Rousso, 3 Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, 56224 Evosmos, Thessaloniki, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Karavas
authors.affiliation: Stamatios Petousis, Chrysoula Margioula-Siarkou, Ioannis Kalogiannidis, George Karavas, Vasileios Palapelas, Nikolaos Prapas, David Rousso, 3 Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, 56224 Evosmos, Thessaloniki, Greece.
authors.forename: Vasileios
authors.initials: V
authors.lastname: Palapelas
authors.affiliation: Stamatios Petousis, Chrysoula Margioula-Siarkou, Ioannis Kalogiannidis, George Karavas, Vasileios Palapelas, Nikolaos Prapas, David Rousso, 3 Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, 56224 Evosmos, Thessaloniki, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Prapas
authors.affiliation: Stamatios Petousis, Chrysoula Margioula-Siarkou, Ioannis Kalogiannidis, George Karavas, Vasileios Palapelas, Nikolaos Prapas, David Rousso, 3 Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, 56224 Evosmos, Thessaloniki, Greece.
authors.forename: David
authors.initials: D
authors.lastname: Rousso
keywords: Cervical pregnancy; Conservative treatment; Effectiveness; Intramuscular; Methotrexate