Combined intrauterine and twin cervical pregnancy managed by a new conservative modality
Shmuel Nitke1, Eran Horowitz, Jacob Farhi
1The Helen Schneider Comprehensive Women's Health Center, Rabin Medical Center, Petach Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Objective:
To describe a rare case of a heterotopic pregnancy with two gestational sacs in the cervix and one in the uterine cavity.
Design:
Case report.
Setting:
Tertiary university hospital.
Patient(S):
A 45-year-old woman was diagnosed with a triplet gestation 7 weeks following IVF treatment for primary infertility of 5 years' duration. Transvaginal ultrasound scan revealed three gestational sacs: one sac inside the uterine cavity containing a live fetus, and two sacs in the uterine cervix, one containing a live fetus and a second empty sac.
Intervention(S):
Pregnancy termination was performed by selective intraarterial catheterization of the uterine artery, intraarterial administration of methotrexate, and uterine artery embolization with Gelfoam.
Main Outcome Measure(S):
Intra- or postprocedural complications and fertility preservation.
Result(S):
The pregnancy termination was successfully performed without intra- or postprocedural complications, with preservation of the patient's fertility.
Conclusion(S):
Intraarterial methotrexate with uterine vessel embolization is an effective conservative approach to heterotopic cervical pregnancy.
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