Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1014-1020
Cervical pregnancy is challenging for the medical community, as it is potentially fatal. The treatment can be medical or surgical; however, there are no protocols that establish the best option for each case. The objective of the present study was to describe the cases of cervical pregnancy admitted to a tertiary university hospital over a period of 18 years.
A retrospective study based on a review of the medical records of all cervical pregnancies admitted to the Women's Hospital at Universidade Estadual de Campinas, Southeastern Brazil, from 2000 to 2018.
We identified 13 cases of cervical pregnancy out of a total of 673 ectopic pregnancies; only 1 case was initially treated with surgery because of hemodynamic instability. Of the 12 cases treated conservatively, 7 were treated with single-dose intramuscular methotrexate, 1, with intravenous and intramuscular methotrexate, 1, with intravenous methotrexate, 1, with 2 doses of intramuscular methotrexate, and 2, with intra-amniotic methotrexate. Of these cases, one had a therapeutic failure that required a hysterectomy. Two women received blood transfusions. Four women required cervical tamponade with a Foley catheter balloon for hemostasis. There was no fatal outcome.
Cervical pregnancy is a rare and challenging condition from diagnosis to treatment. Conservative treatment was the primary method of therapy used, with satisfactory results. In cases of increased bleeding, cervical curettage was the initial treatment, and it was associated with the use of a cervical balloon for hemostasis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(6):347-350
DOI 10.1590/S0100-72031999000600008
Purpose: to evaluate safety and efficacy of intra-amniotic injection of methotrexate (MTX) for treatment of viable cervical pregnancy. Methods: four women with viable cervical pregnancy confirmed by ultrasound (US) were treated with transvaginal injection of MTX (1 mg/kg) under sonographic control. The follow-up was made with serial dosages of beta-hCG on days 1, 4 and 7 after injection and weekly until the titers were negative. Results: the patients were treated with success. The time for the titers of beta-hCG to become negative after the treatment was: 62 days (case 1), 84 days (case 2), 28 days (case 3) and 10 days (case 4). Conclusion: intra-amniotic injection of MTX can be used to avoid surgery in cases of viable cervical pregnancy.