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Korean Journal of Obstetrics & Gynecology 2001;44(8):1483-1487.
Published online August 1, 2001.
Conservative Treatment of Cervical Pregnancy with MTX Followed by Therapeutic Curettage.
E J Kang, H J Kim, M H Kim, E N Cho, H J Kim
Department of Obstetrics and Gynecology, Ilsin Christian Hospital, Pusan, Korea.
Abstract
OBJECTIVE
To evaluate the safety and efficacy of intramuscular methotrexate injection followed by dilatation and curettage (D & C) for the treatment of ectopic cervical pregnancy. METHOD: Nine patients with cervical pregnancy were treated alternately with four doses of intramuscular methotrexate (1.0 mg/kg) and four doses of intramuscular folinic acid (0.1 mg/kg). On the seventh day after treatment, patients were measured for level of serum beta-hCG (human chorionic gonadotropin) and underwent ultrasounds. According to the result, additional dose of MTX or curettage were done. Serum beta-hCG and ultrasound were checked every week until the level of serum beta-hCG and the finding of ultrasound had been normalized. RESULTS: Eight patients showed normal level in serum beta-hCG and normal finding in ultrasound after the methotrexate/folinic acid therapy followed by D & C. One of nine patients showed increase by double concentrations in serum beta-hCG after the MTX/Folinic acid treatment. After intraamnionic injection of MTX, serum beta-hCG titer was decreased in this case. One week later, D & C was performed. No patient was experienced severe complications. All patients who had wanted a subsequent pregnancy were conceived. CONCLUSION: These results suggest that methotrexate/folinic acid therapy followed by D & C is safe and effective as a primary therapy for ectopic cervical pregnancy.
Key Words: Cervical pregnancy, Methotrexate, Dilatation & Curettage


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