ABSTRACT

Cervical pregnancy is an extremely rare form of the ectopic pregnancies. The aim of this case report is to show that single dose methotrexate and vaginal misoprostol could be an alternative therapy to surgery.

A 34 year old, gravida 3, parite 3, patient who had vaginal spotting and 15 days menstrual delay according to her last menstrual cycle, admitted to our hospital. The serum β-hCG level of the patient was 23 000 mIU/ml and transvaginal ultrasound revealed a vacancy in the uterine cavity and the mistaken localization of the gestational sac in the cervical canal. The patient was given a single dose of 50 mg/m2 methotrexate (85mg). Four hundred µg misoprostol was administered to the posterior fornix of the vagina on the second day latter to the methotrexate therapy, repeating dose of misoprostol was given on the third day as no cervical changes were detected, fetal heart rates were lost on the fifth day and finally abortion was achieved on the eighth day. No major bleeding occurred and no surgical intervention needed. The patient then was followed up by sonographic examinations and serum β-hCG measurements.

This ectopic cervical pregnancy case is treated successfully with a single dose methotrexate and misoprostol. In selected cases single dose methotrexate and misoprostol may become a useful alternative to surgical intervention for the management of viable cervical pregnancy.

Keywords: Cervical pregnancy, conservative treatment, methotrexate, misoprostol