Successful conservative management of a live asymptomatic cervical ectopic pregnancy: a case report

Abstract

Cervical ectopic pregnancy (CEP) is a rare and potentially life-threatening condition, accounting for less than 1% of all ectopic pregnancies, with a high risk of severe haemorrhage and fertility loss. A 24-year-old woman presented with 7 weeks of amenorrhoea and a positive serum β-human chorionic gonadotropin test. Transvaginal ultrasonography revealed a well-defined gestational sac in endo-cervical region, having fetal pole, crown-rump length measuring 8.4mm corresponding to 6 weeks 5 days cervical ectopic gestation with cardiac activity. Internal os was closed, Colour Doppler showed significant peritrophoblastic vascularity. Initial management with intramuscular methotrexate was followed by ultrasound-guided intra-gestational sac methotrexate and potassium chloride injection caused gradual decrease of serum β HCG levels and almost disappreance of products of conception within 2 weeks, without the need for additional interventional treatment. Conservative treatment including intramuscular methotrexate followed by intra- gestational sac methotrexate and potassium chloride administration may be effective in treating cervical ectopic pregnancy that even curettage may not be compulsory.