Conservative management of 11 weeks old cervical ectopic pregnancy with transvaginal ultrasound-guided combined methotrexate injection: Case Report and Literature Review

INTRODUCTION: The ultimate treatment approach for cervical ectopic pregnancy remains controversial. Gestational age, serum p-hCG levels, fetal cardiac activity presence and the patient's claim for fertility preservation are the major challenges for method of choice in each individual case. Medical treatment may be a favorable option for the treatment of late diagnosed cases, as well as the early ones. PRESENTATION OF CASE: In this case report, we aim to present a case of 10 4/7 weeks of cervical ectopic pregnancy successfully treated with transvaginal ultrasound-guided local and systemic methotrexate injection. DISCUSSION: The case presented here is exceptional because even though the advanced gestational age, presence of fetal cardiac activity and high serum p-hCG values, the abortion has occurred successfully. Conservative treatment without any need of further surgical intervention was sufficient for full recovery with the preservation of reproductive capacity. CONCLUSION: In conclusion, transvaginal ultrasound guided local and systemic methotrexate injection may be performed successfully for the cases of advanced gestational age with fetal cardiac activity and high serum p-hCG levels. (C) 2020 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.