Ultrasonographic appearance of cervical pregnancy following successful treatment with methotrexate

We report a case of cervical ectopic pregnancy successfully treated with systemic methotrexate. Conservative management with single-dose methotrexate was undertaken, but owing to the failure of human chorionic gonadotropin (hCG) levels to fall by 15% by day 7 and the persistence of fetal cardiac activity, two further doses of methotrexate were required. The patient's bCG levels were monitored, and repeat transvaginal ultrasonograpby was performed until complete resolution of the pregnancy by spontaneous miscarriage. We describe the ultrasonographic findings, which showed that the sac size increased despite treatment. Copyright (c) 2006 ISUOG. Published by John Wiley & Sons, Ltd.