Combined intrauterine and twin cervical pregnancy managed by a new conservative modality.

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.