Methotrexate treatment of cervical pregnancies with different clinical parameters. A report of three cases

Three cases of cervical pregnancy with different clinical parameters were successfully treated with methotrexate. Case 1 was a viable cervical pregnancy, case 2 was a cervical pregnancy after curettage that developed into a cervical hematoma, and case 3 was a cervical pregnancy at an early gestational age. The interval between diagnosis and treatment ranged from 45 to 76 days. The maximum quantitative beta-human chorionic gonadotropin (beta-hCG) levels in cases 1, 2 and 3 were 100,180, 19,093 and 956 mIU/mL, respectively. These patients showed a progressive decline in beta-hCG levels, and ultrasound showed a gradual decrease in the size of the pregnancies. The interval between treatment and beta-hCG resolution ranged from 14 to 59 days. Only in case 2 did side effects occur, including stomatitis and transient elevation of serum transaminase. In view of the risks of standard therapy and patients' desire for fertility, methotrexate treatment may be a therapeutic alternative for cervical pregnancy.