Published online Jan 16, 2015. doi: 10.12998/wjcc.v3.i1.81
Peer-review started: July 30, 2014
First decision: September 16, 2014
Revised: October 9, 2014
Accepted: October 28, 2014
Article in press: December 23, 2014
Published online: January 16, 2015
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/m2) 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 10th and was set in follow-up on a weekly basis. β-HCG values were measured < 10 IU/L on 56th day after MTX administration. Intramuscular administration of MTX may be effective in treatment of cervical pregnancy without additional interventional measures.
Core tip: This case of cervical pregnancy is one amongst few treated successfully with intramuscular administration of methotrexate and intramniotic KCl, without demanding additional interventional treatment. Our paper also summarizes the basic conclusions about conservative treatment of cervical pregnancy, a challenging issue in which no consensus still exists.