Radiology, Vol 191, 773-775, Copyright © 1994 by Radiological Society of North America

ARTICLES

Cervical ectopic pregnancy: results of conservative treatment

MC Frates, CB Benson, PM Doubilet, DN Di Salvo, DL Brown, FC Laing, MS Rein and R Osathanondh
Department of Radiology, Harvard Medical School, Boston, MA 02115.

PURPOSE: To review experience with early sonographic diagnosis and fertility-preserving treatment of cervical ectopic pregnancy. MATERIALS AND METHODS: The authors evaluated 12 consecutive cases of cervical ectopic pregnancy diagnosed with ultrasound (US) and treated with methods that successfully preserved the uterus. Gestational age, sonographic findings, means of conception, and method of treatment were recorded. RESULTS: Gestational age at diagnosis ranged from 5.0 to 7.9 weeks. Cardiac activity was documented in nine cases. Patients were treated as follows: transvaginal US-guided injection of potassium chloride into the embryo or gestational sac (n = 6), uterine artery embolization followed by dilation and evacuation (n = 4), dilation and evacuation after ligation of uterine artery branches (n = 1), and uterine artery embolization followed by administration of systemic methotrexate (n = 1). The cervical pregnancy was successfully ablated with one treatment in all cases. No patient required hysterectomy, and only one patient required transfusion. Two patients subsequently delivered healthy babies; three other patients have been able to conceive successfully. CONCLUSION: When cervical ectopic pregnancy is diagnosed early, US-guided termination or other conservative procedures allow preservation of the uterus, thus maintaining potential fertility.

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