SUBSEQUENT REPRODUCTION AND OBSTETRIC OUTCOME AFTER METHOTREXATE TREATMENT OF CERVICAL PREGNANCY - A REVIEW OF ORIGINAL LITERATURE AND INTERNATIONAL COLLABORATIVE FOLLOW-UP

The case reports of 22 patients with cervical pregnancies treated by m ethotrexate (MTX) administration and published in English literature b etween 1983 and 1995 were reviewed, by either original paper review or follow-up under international collaboration, to determine the subsequ ent reproductive performance and obstetric outcomes, Out of 22 cases, 18 (78%) MTX chemotherapy attempts succeeded with complete remission a nd four (22%) failed, Of the 13 women who wished to conceive and could be followed for at least 3 years, nine succeeded in having live birth s without congenital malformations, one spontaneously aborted and thre e suffered infertility, In general, MTX chemotherapy alone or combined with adjuvant methods such as subsequent cervical curettage or cervic al tamponade, or intracervical potassium chloride injection, appears t o be a convenient and effective method for the treatment of the majori ty of cervical pregnancies before 12 weeks gestation, and has not been shown to have detrimental effects on subsequent reproductive capaciti es, obstetric outcomes and progeny health for those cases with success ful preservation of the uteri.