Document Detail


Viable cervical pregnancy managed with systemic Methotrexate, uterine artery embolization, and local tamponade with inflated Foley catheter balloon.
MedLine Citation:
PMID:  13680510     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We present an unusual case of a primigravida with a viable cervical pregnancy diagnosed by transvaginal ultrasound and magnetic resonance imaging. Staggered conservative therapeutic measures included systemic high-dose Methotrexate with Folinic acid rescue followed by bilateral embolization of the uterine arteries in response to active cervical bleeding despite declining serum beta-human chorionic gonadotropin levels. Continued active cervical bleeding responded to local tamponade with an inflated Foley catheter balloon positioned within the cervical canal. Conservative treatment was successful, with complete resolution of the cervical pregnancy, resumption of normal menstrual cycles, and a normal transvaginal ultrasonographic appearance of the cervical canal, documented 8 weeks after the initial diagnosis. This case and review of the literature support that various staggered conservative hemostatic measures may be used at various points in which bleeding may occur in the conservative management algorithm of cervical pregnancy.
Authors:
David M Sherer; Andrzej Lysikiewicz; Ovadia Abulafia
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  American journal of perinatology     Volume:  20     ISSN:  0735-1631     ISO Abbreviation:  Am J Perinatol     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-09-18     Completed Date:  2004-01-08     Revised Date:  2010-12-01    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  263-7     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, St. Luke's Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / administration & dosage*
Adult
Balloon Dilation
Balloon Occlusion
Cervix Uteri*
Diagnosis, Differential
Embolization, Therapeutic
Female
Humans
Magnetic Resonance Imaging
Methotrexate / administration & dosage*
Parity
Pregnancy
Pregnancy Trimester, First
Pregnancy, Ectopic / pathology,  therapy*,  ultrasonography
Ultrasonography, Prenatal
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 59-05-2/Methotrexate

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