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Case Report

IJMDC. 2019; 3(7): 632-635


Cervical pregnancy successfully treated with US-guided intra-amniotic Methotrexate injection after the failure of IM Methotrexate: a case report

Mai Mokhtar Yousuf, Gamal Mohamed Elaswally.




Abstract

Background:
Cervical pregnancy is a rare ectopic pregnancy caused due to implantation of the ovum in the endocervical canal. In the past, early diagnosis for such condition was not possible as a result this condition often was presented lately to the clinics with life-threatening hemorrhage that frequently required a hysterectomy. At present, there has been tremendous development in the medical field which led to early diagnosis of ectopic pregnancy using ultrasonography (U/S) and sensitive serum 0-hCG assay. Such techniques allow a more conservative therapeutic approach resulting in low morbidity and mortality rates.
Case presentation:
A 38-year-old woman, gravida 2, para 1, was presented with painless vaginal bleeding. Early cervical pregnancy was diagnosed using transvaginal U/S. Intramuscular methotrexate (IM MTX/) therapy was started without success an intra-amniotic injection of MTX was performed under U/S guidance. Pregnancy was terminated successfully, without complications.
Conclusions:
Local MTX is an effective and safe method.

Key words: Cervical pregnancy, methotrexate, conservative treatment






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