Successfully Avoiding Surgery in an Ectopic Cervical Pregnancy
نویسنده
چکیده
The uterine cervix is a rare implantation site for ectopic pregnancy, surgical management should be carefully considered due to the risk of severe hemorrhage associated with this treatment. Methotrexate (MTX) is well documented as an effective medical approach in early gestations and low human chorionic gonadotropin (ß-hCG) levels yielding good results. This is the case,of a 39 year old woman with a 6.5 week old cervical pregnancy. Diagnosis was suspected and later confirmed due to the presence of a late, vaginal hemorrhage and pelvic pain, blood quantitative ß-hCG quantification, clinical exploration and ultrasonographic evaluation. Since the patient was hemodinamically stable and had concerns with her fertility we opted for a medical treatment with MTX in a multiple dose regimen. Treatment was successful after 3 doses (62.5 mg. each, IV infusion), applied on days 1, 3 and 5, using leucovorin (1 g) on alternate days as rescue therapy. Initial ß-hCG levels were reported at 211 mIU/mL, by the time the patient was discharged she had a 77.5% decrease on the ß-hCG levels and diminished symptomatology, after two months follow-up, ß-hCG levels were 0 mIU/mL. Medical management successfully eliminated cervical pregnancy, thus avoiding the risks any invasive procedures may pose.
منابع مشابه
Successful Management of Cervical Ectopic Pregnancy: A Case Report
Background: Cervical ectopic pregnancy is a rare condition with an incidence of less than 0.1% in all ectopic pregnancies. This life-threatening condition is associated with a high morbidity and mortality rates. Recently, the recommended protocol for the treatment of cervical ectopic pregnancy is fertility preservation rather than invasive surgery and hysterectomy. The aim of t...
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