Cervical Ectopic Pregnancy: Persistence Despite a Serologically Negative β-hCG. A Case Report

Area of Science:

• Reproductive Medicine
• Gynecologic Oncology
• Maternal-Fetal Medicine

Background:

• Cervical pregnancy is a rare form of ectopic pregnancy.
• Associated with significant hemorrhage and potential fertility loss.
• Optimal treatment protocols remain not well-established due to rarity.

Observation:

• A 33-year-old woman presented with an 11-week cervical ectopic pregnancy.
• Received multidose methotrexate and leucovorin, with fetal intracardiac potassium chloride injection.
• Achieved undetectable serum β-hCG levels and resumed menses.

Findings:

• Persistent sonographic evidence of cervical ectopic pregnancy despite medical treatment.
• Surgery was ultimately required for complete resolution.
• Highlights limitations of relying solely on β-hCG levels.

Implications:

• Emphasizes the importance of integrating both serum β-hCG monitoring and ultrasound surveillance.
• Suggests a multimodal approach for managing cervical ectopic pregnancies.
• Informs clinical practice for rare obstetric emergencies.