Successful Conservative Treatment for Large Cervical Ectopic Pregnancy
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Abstract
A rare case of cervical ectopic pregnancy presented with vaginal bleeding. Pelvic examination revealed large soft bluish mass at the posterior lip of the cervix. Transvaginal ultrasound showed a cervical mass with a gestational sac and 7-mm fetal echo without cardiac motion. Initial serum beta-human chorionic gonadotropin (hCG) was 29,489 mIU/ml. A two-dose regimen of methotrexate was intramuscularly administered. Bilateral uterine artery embolization was performed on day 14 due to heavy bleeding. One week later, sharp curettage at the cervical implantation site was carried out again because of re-massive bleeding. After discharge, serum beta-hCG levels were normal on day 45. Pathological study confirmed the clinical diagnosis of cervical ectopic pregnancy.
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References
Bouyer J, Coste J, Fernandez H, Pouly JL, Job-Spira N. Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases. Hum Reprod 2002;17:3224-30.
Vela G, Tulandi T. Cervical pregnancy: the importance of early diagnosis and treatment. J Minim Invasive Gynecol 2007;14:481-4.
Hosni MM, Herath RP, Mumtaz R. Diagnostic and therapeutic dilemmas of cervical ectopic pregnancy. Obstet Gynecol Surv 2014;69:261-76.
Barnhart K, Hummel AC, Sammel MD, Menon S, Jain J, Chakhtoura N. Use of “2-dose” regimen of methotrexate to treat ectopic pregnancy. Fertil Steril 2007;87:250-6.
Bachman EA, Barnhart K. Medical management of ectopic pregnancy: a comparison of regimens. Clin Obstet Gynecol 2012;55:440-7.
Ozyuncu O, Tanacan A, Duru SA, Beksac MS. Methotrexate therapy for ectopic pregnancies: a tertiary center experience. Rev Bras Ginecol E Obstet 2018;40:680-5.
Song T, Kim MK, Kim M-L, Jung YW, Yun BS, Seong SJ. Single-dose versus two-dose administration of methotrexate for the treatment of ectopic pregnancy: a randomized controlled trial. Hum Reprod 2016;31: 332-8.
Hu J, Tao X, Yin L, Shi Y. Successful conservative treatment of cervical pregnancy with uterine artery embolization followed by curettage: a report of 19 cases. BJOG 2016;123:97-102.
Lee C-H, Sacks J, Wong M, Cura M, Shaw C. Uterine artery embolization and potassium chloride injection for treatment of cervical pregnancy. J Vasc Interv Radiol 2017;28:1756-8.
Bettaiah R, Kamath SS. Effective hemostasis in cervical ectopic pregnancy with packing without hysterolaparoscopy or devascularization. J Minim Invasive Gynecol 2018;25:322-3.
Yang C, Cai J, Geng Y, Gao Y. Multiple-dose and double-dose versus single-dose administration of methotrexate for the treatment of ectopic pregnancy: a systematic review and meta-analysis. Reprod Biomed Online 2017;34:383-91.
Verma U, Goharkhay N. Conservative management of cervical ectopic pregnancy. Fertil Steril 2009;91: 671-4.
Osada H, Teramoto S, Kaijima H, Segawa T, Miyauchi O, Nagaishi M, et al. A novel treatment for cervical and cesarean section scar pregnancies by transvaginal injection of absolute ethanol to trophoblasts: efficacy in 19 Cases. J Minim Invasive Gynecol 2019;26:129-34.
Gonsalves M, Belli A. The role of interventional radiology in obstetric hemorrhage. Cardiovasc Intervent Radiol 2010; 33:887-95.
Takeda K, Mackay J, Watts S. Successful management of cervical ectopic pregnancy with bilateral uterine artery embolization and methotrexate. Case Rep Emerg Med 2018;2018:9593824.