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Management of early viable cervical pregnancy
Author(s) -
Mesogitis Spiros,
Pilalis Athanasios,
Daskalakis George,
Papantoniou Nikolaos,
Antsaklis Aris
Publication year - 2005
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2004.00447.x
Subject(s) - medicine , curettage , methotrexate , cervical pregnancy , gestational sac , fetus , obstetrics , pregnancy , amniotic sac , gestational age , obstetrics and gynaecology , gestation , amniotic fluid , surgery , ectopic pregnancy , biology , genetics
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.