SONOGRAPHIC EVOLUTION OF A LIVING CERVICAL PREGNANCY TREATED WITH INTRAAMNIOTIC INSTILLATION OF METHOTREXATE

With the wide availability of TVS, CDI, and quantitative assays for se rum beta-HCG, a cervical pregnancy can now be treated more conservativ ely to preserve the patient's potential fertility.(1-3) Medical treatm ent with methotrexate, administered either systemically or locally, ha s been reported to be an effective therapy for a cervical pregnancy wh en diagnosed early.(3-5) However, the relative changes in the cervical mass containing gestational tissue, uterine size, and peritrophoblast ic flow after methotrexate treatment have not been described in detail . We report a case of a living cervical pregnancy treated with intraam niotic instillation of 50 mg of methotrexate under TVS guidance. Seria l changes in the TVS and CDI findings, together with the serum beta-HC G levels after treatment, are described.