Successful treatment of cervical and simultaneous cervico-isthmic pregnancy with methotrexate.

OBJECTIVE

To describe the monitoring of a case of cervical and simultaneous cervico-isthmic pregnancy.

SETTING

University of Bari (Italy), Department of Obstetrics and Gynecology.

PATIENT: A 30-year-old white woman, nulliparous, at 8 weeks of amenorrhoea.

INTERVENTION: Methotrexate and folinic acid administered systemically.

MAIN OUTCOME MEASURE: Treatment success was defined as elimination of the cervical and cervico-isthmic pregnancy, with non-invasive treatment and preservation of the uterus and normal ovarian activity restored.

RESULT: Methotrexate and folinic acid were administered, elimination of a twin pregnancy with declining serum beta-hCG levels and with ultrasound was observed. The patient had only occasional dark vaginal bleeding and temporary movement of the transaminase.

CONCLUSION

This case report shows that methotrexate is a valid, conservative and non-invasive treatment for a patient affected by cervical pregnancy who wishes to keep fertility.