Conservative management of cervical ectopic pregnancy: case report and review of literature

The aim of the study is to describe the management of a case of cervical ectopic pregnancy at six weeks. A 34-year-old patient presented with six weeks of amenorrhea and a cervical pregnancy diagnosed by transvaginal ultrasound. Obstetrical anamnesis showed previous cesarean section and celiac disease as medical complications. At six weeks and one day 50 mg intramuscular methotrexate (MTX) was started and repeated three days later. At six weeks + six days the patient had vaginal bleeding so she was submitted to an emergency surgical procedure consisting of dilatation and curettage followed by a Foley balloon tamponade, which was gradually deflated and removed after two days. Early diagnosis and an appropriate MTX regimen in combination with adjuvant conservative procedures allow successful treatment of a cervical pregnancy, preserving the uterus and future reproductive outcome. However further studies are needed to define the best approach for management of cervical pregnancy.