SUCCESSFUL PREGNANCY AFTER TREATMENT OF CERVICAL PREGNANCY WITH METHOTREXATE AND CURETTAGE - A CASE-REPORT

Cervical pregnancy teas diagnosed in a nulliparous, 28-year-old woman who presented with intermittent vaginal spotting at 12 weeks gestratio n. Sonographic evaluation revealed ct cervical gestational sac with a fetus with cardiac activity. Methotrexate was instilled intraamniotica lly, followed by an intramuscular injection with folinic acid rescue. On the seventh day of treatment an uneventful curettage was performed because of persistent fetal viability. Five months Inter pregnancy occ urred. The patient vaginally delivered a healthy, 3,080-g neonate at 4 0 weeks of gestation. To our knowledge, only nine other cervical pregn ancies have been managed medically with either methotrexate or etoposi de. It seems that first-trimester cervical pregnancies, especially tho se at less than nine weeks of gestation, can be effectively treated wi th methotrexate. Successful medical therapy must be considered, not on ly for regression of the gestation but also for preservation of anatom ic integrity and fertility. Four of the above patients, including ours , had it subsequent intrauterine pregnancy, and one of those pregnanci es terminated in spontaneous abortion.