UĞUREL, Vedat Trakya Üniversitesi - Tıp Fakültesi - Kadın Hastalıkları ve Doğum Anabilim Dalı, Türkiye , ASLAN, Mehmet Musa Trakya Üniversitesi - Tıp Fakültesi - Kadın Hastalıkları ve Doğum Anabilim Dalı, Türkiye

The alternating successive use of two treatment modalities in two cervical pregnancy cases

17606

Cervical pregnancy is a rare form of ectopic pregnancy which implants in the endocervical canal. Nowadays with early diagnosis it is possible to terminate cervical pregnancies before life threatening vaginal bleeding starts and hence the need for hysterectomy is reduced in these women of reproductive age. For this purpose, systemic methotrexate and ultrasound guided needle aspiration of gestational sac are two easy-to-implement treatment modalities. Two cervical pregnancy cases were treated consecutively in alternative orders with systemic single dose intravenous methotrexate at 50 mg/m² dose and 50 mg local methotrexate administered after transvaginal ultrasound assisted needle aspiration of the gestational sac. In the second case, a vacuum aspiration of the cervical canal was necessary due to the higher β-hCG levels (23898 mIU/ml versus1881 mIU/ml) at the beginning of the treatment. While it took 8 weeks for β-hCG level to reach undetectable levels in the first case, it took merely 1 week after vacuum aspiration of the cervical canal in the second case. In this case report, we discuss the successive use and the efficacy of two methods in termination of cervical pregnancies with review of the literature.

175

CervixUteri , Curettage , Hemorrhage , Methotrexate , Pregnancy , Ectopic , Ultrasonography

Fırat Medical Journal

178