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Cervical Ectopic Pregnancy: A Management Dilemma

Case reports

Abstract

A  28-year-old  G3P1+1  at  6  weeks  period  of  amenorrhea  with  a previous  Caesarean  section  presented  with  per vaginal  bleeding.  A cervical  ectopic  pregnancy  was  confirmed  by  a  transvaginal  scan.  An intramuscular methotrexate  was  given followed by intracervical route due to poor decline of the serum βHCG. However, due to persistent increment of serum βHCG, an additional four doses of intramuscular methotrexate with folinic acid rescue were administered and she responded well to the regime. Unfortunately, following the last dose, she developed an episode  of  excessive  per  vaginal  bleeding  which  required  suction  and  curettage  of  the  cervical  canal.  A Foley‘s catheter balloon was placed intracervically as a tamponade and the bleeding was successfully arrested.