Low-dose methotrexate administration in the management of cervical pregnancy

Objective: Cervical pregnancy is a rare form of ectopic pregnancy. There is the risk of hysterectomy when this type of ectopic pregnancy is managed with surgery. An established form of conservative treatment is the administration of methotrexate (MTX). We demonstrate the effectiveness of a low-dose MTX regimen. Materials and Methods: Case analysis of cervical pregnancies at a tertiary referral center at an University Hospital. Six patients presented with cervical or isthmocervical pregnancies. Low-dose of MTX was administered intravenously. Secondary surgical intervention was carried out when needed. The main outcome measures were to preserve childbearing capacity using conservative treatment partly followed by curettage for cervical pregnancyResults: Six patients received conservative treatment with MTX in a low-dose regimen. During the course of conservative treatment with MTX, three patients underwent curettage. One of these patients also received an intra-amniotic administration in addition to systemic administration of MTX. Conclusions: Systemic low-dose methotrexate treatment is an effective form of primary treatment, with a low rate of side effects.