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Re: A case of cervical pregnancyFrom: George M. Grunert (grunert@ICSI.Net)Mon Apr 28 09:29:17 1997
> Asymptomatic 27 y/o primigravida with a live 9.3 wk cervical pregnancy, was > managed with 4 doses of MTX (59 mg IM every 2 days), with leucovorin > rescue. Now, the US finds a 10.1 wk pregnancy, embryo still alive, no > chorial abnormalities. Sub beta hCG levels were initially 66273, three > days later 61599, and now 46628 mIU/ml. Pt still asymptomatic. > In my less than extensive experience with advanced cervical pregnancies with a living fetus (3 cases), only one responded to parenteral MTX. She was treated at 10 weeks with no apparent effect on the growing fetus. This case resulted in hysterectomy following similar failure of arterial embolization. Presumably being older (and perhaps wiser), the next two were treated with intraamniotic injection of MTX. This resulted in cessation of fetal cardiac activity and successful resolution without hysterectomy.
-- George M. Grunert, M.D. Director ART Program, Woman's Hospital of Texas 7550 Fannin Houston, TX 77054 713-512-7851 fax 713-512-7853 grunert@icsi.net
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