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Treatment of cervical pregnancy with methotrexate
Author(s) -
Hung T.H.,
Jeng C.J.,
Yang Y.C.,
Wang K.G.,
Lan C.C.
Publication year - 1996
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/0020-7292(96)02653-7
Subject(s) - methotrexate , medicine , cervical pregnancy , ectopic pregnancy , gestation , pregnancy , gestational sac , obstetrics , chemotherapy , gestational age , hysterectomy , surgery , gynecology , biology , genetics
Objectives: To review our experience with early ultrasonographic diagnosis and fertility‐preserving complete medical treatment of cervical pregnancy. Methods: From January 1989 to December 1994, 11 cases of cervical pregnancy diagnosed by ultrasonography and treated with methotrexate were evaluated. Patients were treated as follows: systemic administration of methotrexate with leucovorin rescue, a single dose of 50 mg of methotrexate intramuscular injection, or transvaginal ultrasonographically‐guided intra‐amniotic instillation of 50 mg methotrexate. Results: The mean age of these patients was 33.3 ± 6.2 years and gestational age at diagnosis ranged from 32 to 73 days. The maximal serum β‐hCG measured was 135 000 mIU/ml, and the time required for return to normal levels ranged from 20 to 157 days. The ectopic gestation was successfully ablated in all cases, and none required hysterectomy. Conclusion: If a cervical pregnancy is present and diagnosed early, methotrexate treatment, administered either systemically or locally, is effective as the definitive therapy.