Successful Management of Viable Cervical Pregnancy by Local Injection of Methotrexate Guided by Transvaginal Ultrasonography

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We evaluated the feasibility of transvaginal methotrexate injection of viable cervical pregnancies to avoid complications of the "classic" surgical procedures in use and to preserve future fertility.Five viable cervical pregnancies, at 6 to 8 weeks, were treated. In three patients a spring-loaded automated puncture device and in two a manually operated simple needle guide mated to and guided by a transvaginal ultrasonography probe were used with 21-gauge needles. The puncture and injection treatment was successful and without complications in all five cases presented. This procedure may become a useful alternative to other, more radical or complex surgical approaches. (AM J OBSTET GYNECOL 1994;170:737-9.)

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