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Re: Isthmical-Cervical_ectopic_pregnancyFrom: Allen Worrall (jworrall@alaska.net)Wed Jun 6 10:29:43 2001
I have little personal experience with cervical pregnancies. It is hard for me to believe that a cervical ectopic pregnancy would be relatively asymptomatic at 10.2 weeks. It would seem more likely that this is a cervical incompetence (10 weeks is early for a loss due to cervical incompetence). In other words, the pregnancy is just falling out of the uterus. It is also hard to believe that this is a spontaneous abortion in progress, with no bleeding or contractions. Can the placenta be seen? Where is it implanted? Does the fetus measure 10.2 weeks? If it is a cervical pregnancy of 10.2 weeks, is methotrexate a good approach? I do not know, but we certainly would not use methotrexate for a tubal ectopic that large! On the other hand, if it is a cervical ectopic pregnancy, methotrexate might cause fetal demise, lessen the vascularity, and thus make surgery safer after a few weeks. Cecilia, you are very wise to seek the advice of the world in this case. I hope you can post some images, and give us follow-up information. Joseph A Worrall MD RDMS
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