The use of methotrexate and arterial embolization to avoid surgery in a case of cervical pregnancy

Objective: To describe the management of a case of cervical ectopic pregnancy (EP). Design: Case report. Setting: University-affiliated teaching hospital. Patient(s): A 26-year-old woman, gravida 4, para 0-1-2-0, with the diagnosis of a cervical EP. Intervention(s): Systemic methotrexate (MTX) and arterial embolization. Results: A cervical EP was diagnosed by ultrasonography. The patient was treated with systemic MTX. Vaginal bleeding began 4 days later and was treated with arterial embolization, thus eliminating the need for surgical intervention. The pregnancy resolved and the patient has resumed normal menstruation and again is attempting pregnancy. Conclusion(s): Arterial embolization can be used to avoid surgical intervention in cases of cervical EP in which hemorrhage occurs after treatment with chemotherapy. (C) 1997 by American Society for Reproductive Medicine.