Conservative management of cervical pregnancy with embryonic heart activity by ultrasound-guided local injection: an eight case series

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2014-09-01
Autores
Elito Junior, Julio [UNIFESP]
Musiello, Rubens Bermudes [UNIFESP]
Araujo Junior, Edward [UNIFESP]
Souza, Eduardo [UNIFESP]
Fava, Jair Luiz [UNIFESP]
Guerzet, Eduardo Almeida [UNIFESP]
Camano, Luiz [UNIFESP]
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Objective: To evaluate the efficacy of conservative management of cervical pregnancy with embryonic heart activity by ultrasound-guided local injection.Methods: Retrospective case series at University tertiary care Hospital. Eight patients diagnosed with cervical pregnancy with embryonic heart activity managed conservatively. the intervention was ultrasound-guided local injection of methotrexate (1 mg/kg) and potassium chloride (2 meq/mL). Measurements were occurrence of morbidity, necessity for further intervention, the initial titers of beta-hCG, interval of time in which the levels of beta-hCG became negative, period for regression of cervical pregnancy at ultrasound and future pregnancy.Results: All patients were treated successfully. the initial levels of beta-hCG ranged from 3013 to 71199 mUI/mL. One case evaluated with infection. There was no need for additional intervention in our series study. the interval of time for the levels of beta-hCG becomes negative range from 2 to 12 weeks. the period for the regression of the cervical pregnancy at ultrasound range from 3 to 14 weeks. in two cases intrauterine pregnancies occurred after the treatment.Conclusion: Conservative management of cervical pregnancy with embryonic heart activity by ultrasound-guided injection is an effective treatment avoiding the need of further intervention.
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Journal of Maternal-fetal & Neonatal Medicine. London: Informa Healthcare, v. 27, n. 13, p. 1378-1381, 2014.
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