Publication:

A rare case of cervical ectopic: potential life-threatening condition managed conservatively with uterine artery embolisation and Methotrexate

A case of cervical pregnancy managed successfully in Medical College, Kolkata by injection Methotrexate and uterine artery embolization. Cervix is a rare implantation site for ectopic pregnancy. Either during surgical management should be carefully considered due to the risk of severe hemorrhage. A 33 years old patient (P2+4 with 1 living issue) with USG diagnosed 6 weeks cervical pregnancy was admitted in Gynaecology and Obstetrics department of Medical College, Kolkata with slight bleeding per vaginum and pain abdomen. USG was repeated along with beta hCG quantification and other routine investigations. Following admission, the bleeding and pain subsided. Patient was counselled regarding the prognosis and management options available. The patient was desirous to preserve her fertility and as the patient was hemodynamically stable with low initial beta hCG of 5200 mIU/ml, we opted for a medical treatment with MTX and uterine artery embolization. Following treatment with 3 doses of weekly Methotrexate (50 mg/m2 each i.m.) and UAE the beta hCG reduced significantly. The patient was discharged with advice of weekly follow up with beta hCG report. Within 2 months of follow-up, ß-hCG level was <10 mIU/mL with TVS showing normal cervical canal and empty uterine cavity.