CERVICAL ECTOPIC PREGNANCY - RESULTS OF CONSERVATIVE TREATMENT

PURPOSE: To review experience with early sonographic diagnosis and fer tility-preserving treatment of cervical ectopic pregnancy. MATERIALS A ND METHODS: The authors evaluated 12 consecutive cases of cervical ect opic pregnancy diagnosed with ultrasound (US) and treated with methods that successfully preserved the uterus. Gestational age, sonographic findings, means of conception, and method of treatment were recorded. RESULTS: Gestational age at diagnosis ranged from 5.0 to 7.9 weeks. Ca rdiac activity was documented in nine cases. Patients were treated as follows: transvaginal US-guided injection of potassium chloride into t he embryo or gestational sac (n = 6), uterine artery embolization foll owed by dilation and evacuation (n = 4), dilation and evacuation after ligation of uterine artery branches (n = 1), and uterine artery embol ization followed by administration of systemic methotrexate (n = 1). T he cervical pregnancy was successfully ablated with one treatment in a ll cases. No patient required hysterectomy, and only one patient requi red transfusion. Two patients subsequently delivered healthy babies; t hree other patients have been able to conceive successfully. CONCULSIO N: When cervical ectopic pregnancy is diagnosed early, US-guided termi nation or other conservative procedures allow preservation of the uter us, thus maintaining potential fertility.