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KMID : 0191120040190060848
Journal of Korean Medical Science
2004 Volume.19 No. 6 p.848 ~ p.852
Clinical Outcomes of Patients treated for Cervical Pregnancy with or without Methotrexate
Kim TJ
Seong SJ/Lee KJ/Lee JH/Shin JS/Lim KT/Chung HW/Lee KH/Park IS/Shim JU/Park CT
Abstract
The objective of this study is to describe the clinical outcomes of patients treated for cervical pregnancy with or without methotrexate (MTX) and to evaluate the effects of MTX in the treatment of cervical pregnancy. Between January 1993 and February 2000, 31 patients were diagnosed with cervical pregnancy. Twenty-two patients were treated with MTX chemotherapy and nine patients were treated with surgical procedures without MTX treatment. In the non-MTX treatment group, three patients underwent total abdominal hysterectomy, five required adjuvant procedures to control the bleeding during dilatation and curettage (D&C) and only one patient was treated with a simple D&C. In the MTX treatment group, fourteen (63.6%) patients were treated with only MTX and eight (36.4%) cases underwent concomi-tant procedures (simple curettage, curettage and Foley catheter tamponade, cer-vical cerclage, ligation of the descending branches of uterine arteries, or ligation of hypogastric arteries). The uterus was preserved in all cases and three women delivered healthy babies in their subsequent pregnancy. In conclusion, early diag-nosis, appropriate MTX regimen in combination of necessary adjuvant conserva-tive procedures could contribute to successful treatment with preservation of the uterus and future reproductive ability.
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