Cervical ectopic pregnancy managed with methotrexate and tranexamic acid: A case report

Area of Science:

• Reproductive Medicine
• Gynecology

Background:

• Cervical pregnancy is a rare but life-threatening ectopic pregnancy.
• Management decisions are challenging, with surgery often leading to hysterectomy due to hemorrhage.
• Conservative management options are being explored for uterine preservation.

Observation:

• A 29-year-old primiparous woman with gestational diabetes presented with symptoms of cervical pregnancy at 10 weeks gestation.
• Pelvic exam revealed a disproportionately enlarged cervix with a closed internal os; ultrasound confirmed a live cervical pregnancy.

Findings:

• The patient received conservative management with intramuscular methotrexate and tranexamic acid.
• This was followed by suction evacuation and balloon tamponade, successfully treating the cervical pregnancy.

Implications:

• Medical management as a first-line option for cervical pregnancy offers uterine preservation.
• This approach can be a viable alternative to immediate hysterectomy in selected cases.