Cervical ectopic pregnancySuccessful management by combined systemic methotrexate, bilateral uterine embolization and suction evacuation

Abstract

: A 31-year female, G4P2L2A1 with two previous cesarean deliveries and one dilatation and curettage, was diagnosed with cervical ectopic pregnancy of 8 weeks and two days without any cardiac activity. She had a complaint of slight pain in the abdomen without any bleeding per vagina. She was initially managed with multi-dose systemic methotrexate therapy. The value of beta-HCG decreased by about 70%. She then underwent bilateral uterine artery embolization followed by ultrasound-guided suction evacuation with descending cervical artery ligation with cervical balloon tamponade. The patient was asymptomatic throughout her hospital stay. Her beta-HCG value dropped to 10 IU/ml and usg showed empty endocervical canal on weekly follow-up.: Conservation methods like systemic methotrexate or potassium chloride, along with minimally invasive techniques like bilateral uterine artery embolization, are among the most effective and safe fertility-sparing modalities in managing cervical ectopic pregnancy. Proper case selection and availability of required infrastructure at tertiary care centers are mandatory.