The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Case Report: A cervical pregnancy successfully treated with methotrexate and curettage

Document Type : Case report

Authors
Malihe Afiat 1
Somayeh Moeen Darbari 2
Behnaz Ansari 2
Marzieh Lotfalizadeh 3
Seyedeh Houra Vahedalain 1
1 Assistant Professor, Department of Obstetrics and Gynecology, Women's Health Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Resident, Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Associate Professor, Department of Obstetrics and Gynecology, Women's Health Research Center, school of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
10.22038/ijogi.2015.4575
Abstract
Introduction: Cervical pregnancy is a rare type of ectopic pregnancy with replacement of pregnancy products in endocervical canal that allocates 1% of this type of pregnancies. The cause of this type of pregnancy is unknown and the local injury on the cervix and uterus due to previous surgery, such as curettage and cesarean is a probable cause of cervical pregnancy. Also, cervical pregnancy with higher prevalence is observed in ectopic pregnancy by IVF. This study is a case report of cervical pregnancy and its treatment.
Case report: The introduced case was a 19 year old woman, gravid 2, with history of curettage due to abortion about one year ago. The patient underwent transvaginal sonography because of 1.5 months menstrual retardation and spotting from 2 weeks earlier to diagnose the pregnancy status. The sonography reported a regular gestation sac with decidual reaction in the endocervical canal. Regarding the stable vital sign, the patient underwent treatment with systemic and local methotrexate. Then due to bleeding and tissue excretion, she underwent curettage.
Result: Early diagnosis and treatment of cervical pregnancy is important to avoid profusing hemorrhage that results in hysterectomy that is mother's life-threatening. In this introduced case, due to early diagnosis the fertility of patient was reserved successfully without morbidity. Undoubtedly, in the case of using techniques such as uterine arterial embolization with methotrexate, the incidence of vaginal bleeding and the need to curettage would be reduced and it would prevent creating risk factors for recurrent cervical pregnancy. 
Keywords
Cervical pregnancy
ectopic pregnancy
Methotrexate
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