• J Reprod Med · Feb 2003

    Case Reports

    Methotrexate for cervical pregnancy. A case report.

    • Cetin Celik, Ayfer Bala, Ali Acar, Kazim Gezginç, and Cemalettin Akyürek.
    • Department of Obstetrics and Gynecology, Selçuk University Faculty of Medicine, Akyokuş, 42080 Konya, Turkey. celikcet@hotmail.com
    • J Reprod Med. 2003 Feb 1; 48 (2): 130-2.

    BackgroundThe incidence of cervical pregnancy is 1:1,000-95,000 pregnancies and represents < 1% of all ectopic pregnancies. Evacuation of the pregnancy by curettage does not always stop the bleeding because there is little contractile muscle in the cervix. If there is uncontrollable bleeding, hysterectomy is necessary. In selected cases, nonsurgical management offers high success rates. Among medical treatments, the most common is systemic or local administration of methotrexate.CaseA 36-year-old woman, gravida 2, para 2, presented with vaginal bleeding and subacute pain in the lower abdomen. The patient was 7 weeks' pregnant according to her last menstrual period. Transvaginal ultrasonography showed a gestational sac of approximately 5 weeks' gestational age implanted in the wall of the cervix. Fifty milligrams of methotrexate was injected into the gestational sac and another 50 mg administered intramuscularly. The hCG level decreased continuously and was no longer detectable after 35 days.ConclusionThe use of methotrexate for cervical pregnancy is safe and effective and preserves fertility.

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