Two cases of conservative management of 10 and 8 week cervical pregnancies.

Kim, Seong Eun; Kim, Myoung Chan; Shin, Se Won; Ha, Sang Byum; Choi, Yong Seok; Jo, Bong Choon

Case Report

Korean Journal of Obstetrics & Gynecology 1999;42(9):2088-2093.
Published online January 1, 2001.

Two cases of conservative management of 10 and 8 week cervical pregnancies.

Seong Eun Kim, Myoung Chan Kim, Se Won Shin, Sang Byum Ha, Yong Seok Choi, Bong Choon Jo

Abstract

Cervical pregnancy is a rare and dangerous form of ectopic pregnancy in which the blastocyst implants within the cervical canal below the internal os of the uterine cervix. The characteristic clinical sign is a severe asymptomatic uterine bleeding in early pregnancy or during curettage. Most cervical pregnancies result in early spontaneous abortion, complicated by severe hemorrhage from the eroded blood vessels within the cervical tissue. Because of uncontrolled profuse vaginal bleeding, total hysterectomy has been the mostly necessitated to control life-threatening bleeding. Transvaginal sonography allows early diagnosis, and conservative treatment (two-time treatment : first treatement with systemic or intraamnionic methotrexate, secondly with curettage or ligature of the uterine arteries) improves the patient's fertility. Successful treatment is defined as elimination of the cervical pregnancy with preservation of the uterus. We report two cases of cervical pregnancy managed, successfully with methotrexate, leucovorin and curettage.

Key Words: Cervical pregnancy, Methotrexate