Successful Transvaginal Aspiration of Cervical Pregnancy aft
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Cervical pregnancies are infrequent and fatal. Systemic methotrexate (MTX) treatment is conventionally administered to preserve fertility and prevent hemorrhage. Conservative management constitutes first-line treatment for individuals desiring future pregnancy. Herein, presented the cases of two patients with cervical pregnancy conceived through IVF. In both cases, treatment with transvaginal aspiration of the cervical gestational sacs was successful.

Case 1
A primiparous 38-year-old woman with cervical pregnancy induced through IVF-embryo transfer (IVF-ET) received multidose methotrexate (MTX); however, the gestational sac enlarged with an increase in ?-human chorionic gonadotropin (hCG) levels, indicating treatment failure. Transvaginal aspiration was hence suggested. On the day of aspiration, the ?-hCG level was 20585 mIU/mL, and fetal pole was observed (Figure 1). The gestational sac was undetectable upon sonography a week after aspiration and the ?-hCG levels (determined serially) reverted to normalcy 2 months after the procedure.

Case 2
A primiparous 36-year-old woman with cervical pregnancy induced through IVF-ET (Figure 2) received systemic multidose MTX, which did not exert any therapeutic effects. On the day of aspiration, the ?-hCG level was 8061.85 mIU/mL. Two weeks after aspiration, her ?-hCG level was undetectable.

Results suggest that transvaginal aspiration should be considered an alternative upon failure of systemic MTX treatment or in the presence of contraindications for MTX injection. A prompt diagnosis of cervical pregnancy would guarantee the success of conservative treatment.

Source: https://gynecology-obstetrics.imedpub.com/successful-transvaginal-aspiration-ofcervical-pregnancy-after-failed-methotrexatetreatment-a-case-report.php?aid=26370
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