Combined intrauterine and twin cervical pregnancy managed by a new conservative modality

Shmuel Nitke, Eran Horowitz*, Jacob Farhi, Haim Krissi, Josef Shalev

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To describe a rare case of a heterotopic pregnancy with two gestational sacs in the cervix and one in the uterine cavity. Design: Case report. Setting: Tertiary university hospital. Patient(s): A 45-year-old woman was diagnosed with a triplet gestation 7 weeks following IVF treatment for primary infertility of 5 years' duration. Transvaginal ultrasound scan revealed three gestational sacs: one sac inside the uterine cavity containing a live fetus, and two sacs in the uterine cervix, one containing a live fetus and a second empty sac. Intervention(s): Pregnancy termination was performed by selective intraarterial catheterization of the uterine artery, intraarterial administration of methotrexate, and uterine artery embolization with Gelfoam. Main Outcome Measure(s): Intra- or postprocedural complications and fertility preservation. Result(s): The pregnancy termination was successfully performed without intra- or postprocedural complications, with preservation of the patient's fertility. Conclusion(s): Intraarterial methotrexate with uterine vessel embolization is an effective conservative approach to heterotopic cervical pregnancy.

Original languageEnglish
Pages (from-to)706.e1-706.e3
JournalFertility and Sterility
Volume88
Issue number3
DOIs
StatePublished - Sep 2007
Externally publishedYes

Keywords

  • Cervical pregnancy
  • heterotopic pregnancy
  • intraarterial methotrexate
  • uterine artery embolization

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