title: Vaginal Hysterectomy for Treatment of Cervical Ectopic Pregnancy.
abstract: Cervical ectopic pregnancy can lead to catastrophic hemorrhage, and may be managed conservatively with intra-amniotic methotrexate (MTX), systemic MTX, or both; surgical evacuation with or without balloon tamponade; and uterine artery embolization. However, some patients require hysterectomy, which has traditionally been performed abdominally.
  
  
  
  A 39-year-old parous woman was diagnosed with cervical ectopic pregnancy at an estimated 7 1/7 weeks of gestation. Her β-hCG level remained at 29,433 milli-international units/mL, and the gestational sac persisted on ultrasonography after first intra-amniotic then multidose systemic MTX treatment. After a review of other fertility-sparing procedures, she chose definitive treatment with hysterectomy because she did not desire future childbearing. She underwent a successful vaginal hysterectomy, a novel approach for this condition.
  
  
  
  Vaginal hysterectomy can be performed successfully for treatment of cervical ectopic pregnancy in patients who have completed childbearing and for whom conservative treatment has failed.
authors.affiliation: Departments of Obstetrics and Gynecology, Tufts University School of Medicine, Baystate Medical Center, Springfield, Massachusetts.
authors.forename: Roa
authors.initials: R
authors.lastname: Alammari
authors.forename: Renee
authors.initials: R
authors.lastname: Thibodeau
authors.forename: Oz
authors.initials: O
authors.lastname: Harmanli
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use; D000328:Adult; D002584:Cervix Uteri; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal; D008727:Methotrexate / Q000627:therapeutic use; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate