ISSN 1308-8734 | E-ISSN 1308-8742
Case Report
Combined Systemic and Hysteroscopic Intra-Amniotic Injection of Methotrexate Associated with Hysteroscopic Resection for Cervical Pregnancy: A Cutting-Edge Approach for an Uncommon Condition
1 Department of Public Health, University of Naples “Federico II”, Naples, Italy  
2 Department of Gynecology and Obstetrics, ABC Foundation School of Medicine, Santo André, Brazil  
3 Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood ‘‘G. Barresi’’, University of Messina, Messina, Italy  
4 Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, Italy  
Eurasian J Med 2017; 49: 66-68
DOI: 10.5152/eurasianjmed.2017.16215
Key Words: Hysteroscopy, methotrexate, cervical pregnancy

This case report of a 36-year-old woman with a diagnosis of cervical pregnancy describes a novel approach to this rare form of ectopic pregnancy, which was successfully treated with systemic and local methotrexate (MTX) therapy combined with hysteroscopic resection. After local and systemic administration of MTX, the patient underwent hysteroscopic resection of the cervical pregnancy using a 27 bipolar resectoscope with a 4-mm loop. The cervical pregnancy was completely treated, and satisfactory hemostasis was achieved with electrocoagulation. The reported case and literature review demonstrate that the combination of systemic and local (hysteroscopic) administration of MTX with hysteroscopic resection could offer the possibility of a safe, successful, minimally invasive, and fertility-sparing surgical treatment for cervical pregnancy.

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