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Case Reports
. 2012 Oct;28(5):369-371.
doi: 10.1089/gyn.2012.0006.

Hysteroscopic Removal of Cervical Ectopic Pregnancy Following Failed Intramuscular/Intra-Sac Methotrexate: A Case Report

Jason D Kofinas  1 , Stephanie E Purisch  1 , Justin S Brandt  1 , Melissa Montes  2
Affiliations
Case Reports

Hysteroscopic Removal of Cervical Ectopic Pregnancy Following Failed Intramuscular/Intra-Sac Methotrexate: A Case Report

Jason D Kofinas et al. J Gynecol Surg. 2012 Oct.

Abstract

Background: Cervical pregnancy is a diagnosis associated with significant morbidity, specifically life-threatening hemorrhage that potentially requires hysterectomy to prevent maternal death. Conservative and fertility-sparing management strategies are poorly described in the literature, and there is no clear standard of care. Case: The patient was a 34-year-old gravida 1, para 0 who had conceived spontaneously after laparoscopic treatment of endometriosis, and was found to have cervical pregnancy. She received both intramuscular and intra-sac methotrexate, with no resolution of the ectopic pregnancy. The pregnancy was removed hysteroscopically. Results: Subsequently, the patient was able to achieve a normal clinical pregnancy with ovulation induction/intrauterine insemination. This pregnancy was carried to term. Conclusions: Although cervical pregnancy is particularly hazardous and potentially fatal, conservative/fertility-sparing management of these pregnancies can be successful. (J GYNECOL SURG 28:369).

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Figures

FIG. 1.
FIG. 1.
Sonographic evidence of cervical pregnancy within the cervical canal.
FIG. 2.
FIG. 2.
Sonographic image showing distance of cervical pregnancy from ectocervix.
FIG. 3.
FIG. 3.
Cervical pregnancy within the right cervical canal.
FIG. 4.
FIG. 4.
Empty uterine cavity after resection of cervical pregnancy.
See this image and copyright information in PMC

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