IngentaConnect Management of early viable cervical pregnancy

Authors: Mesogitis, Spiros; Pilalis, Athanasios; Daskalakis, George; Papantoniou, Nikolaos; Antsaklis, Aris

Source: BJOG: An International Journal of Obstetrics & Gynaecology, Volume 112, Number 4, April 2005 , pp. 409-411(3)

Publisher: Blackwell Publishing

Abstract:

Objective

To evaluate conservative management of early viable cervical pregnancy. Design

Prospective study. Setting

A tertiary teaching hospital. Population

All cases of cervical pregnancies with fetal cardiac activity presenting to our hospital over six years. Methods

All cases were managed with trans-abdominal intra-amniotic injection of 25 mg of methotrexate under ultrasound guidance. Follow up sonographic examinations and serum β-hCG measurements were performed every three days. Cervical curettage was performed after two follow up ultrasound examinations had shown a dead fetus and a regressing gestational sac as well as declining β-hCG levels. Patients were managed as outpatients. Main outcome measures

Successful management and need for hospitalisation. Results

Nine cases were encountered. Two required a second injection of methotrexate for persistent fetal cardiac activity and serum β-hCG rise in the follow up examination. We did not observe any side effects and no patient required admission to the hospital. Conclusions

Intra-amniotic methotrexate injection and subsequent cervical curettage after one week is a successful alternative for the management of cervical pregnancies.

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