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Successful treatment of cervical and simultaneous cervico-isthmic pregnancy with methotrexate
G A Melilli1, G Cormio, G Putignano
1Department of Obstetrics and Gynecology, University of Bari, Italy.
Objective:
To describe the monitoring of a case of cervical and simultaneous cervico-isthmic pregnancy.
Setting:
University of Bari (Italy), Department of Obstetrics and Gynecology.
Patient:
A 30-year-old white woman, nulliparous, at 8 weeks of amenorrhoea.
Intervention:
Methotrexate and folinic acid administered systemically.
Main Outcome Measure:
Treatment success was defined as elimination of the cervical and cervico-isthmic pregnancy, with non-invasive treatment and preservation of the uterus and normal ovarian activity restored.
Result:
Methotrexate and folinic acid were administered, elimination of a twin pregnancy with declining serum beta-hCG levels and with ultrasound was observed. The patient had only occasional dark vaginal bleeding and temporary movement of the transaminase.
Conclusion:
This case report shows that methotrexate is a valid, conservative and non-invasive treatment for a patient affected by cervical pregnancy who wishes to keep fertility.