Conservative management of cervical pregnancy with embryonic heart activity by ultrasound-guided local injection: an eight case series

• Published in: The journal of maternal-fetal & neonatal medicine 2014-09, Vol.27 (13), p.1378-1381
• Main Authors: Júnior, Julio Elito, Musiello, Rubens Bermudes, Araujo Júnior, Edward, Souza, Eduardo, Fava, Jair Luiz, Guerzet, Eduardo Almeida, Camano, Luiz
• Format: Article
• Language: English
• Subjects: Abortifacient Agents, Nonsteroidal - administration & dosage; Adult; Cervical pregnancy; conservative management; Female; Humans; methotrexate; Methotrexate - administration & dosage; Potassium Chloride - administration & dosage; potassium chloride injection; Pregnancy; Pregnancy, Ectopic - diagnostic imaging; Pregnancy, Ectopic - drug therapy; Pregnancy, Ectopic - surgery; Retrospective Studies; Ultrasonography, Interventional; ultrasound; Uterine Cervical Diseases - drug therapy
• ISSN: 1476-7058; 1476-4954
• DOI: 10.3109/14767058.2013.856413

Abstract Objective: To evaluate the efficacy of conservative management of cervical pregnancy with embryonic heart activity by ultrasound-guided local injection. Methods: Retrospective case series at University tertiary care Hospital. Eight patients diagnosed with cervical pregnancy with embryonic heart activity managed conservatively. The intervention was ultrasound-guided local injection of methotrexate (1 mg/kg) and potassium chloride (2 meq/mL). Measurements were occurrence of morbidity, necessity for further intervention, the initial titers of beta-hCG, interval of time in which the levels of beta-hCG became negative, period for regression of cervical pregnancy at ultrasound and future pregnancy. Results: All patients were treated successfully. The initial levels of beta-hCG ranged from 3013 to 71199 mUI/mL. One case evaluated with infection. There was no need for additional intervention in our series study. The interval of time for the levels of beta-hCG becomes negative range from 2 to 12 weeks. The period for the regression of the cervical pregnancy at ultrasound range from 3 to 14 weeks. In two cases intrauterine pregnancies occurred after the treatment. Conclusion: Conservative management of cervical pregnancy with embryonic heart activity by ultrasound-guided injection is an effective treatment avoiding the need of further intervention.