Methotrexate treatment of cervical pregnancies with different clinical parameters: A report of three cases

Three cases of cervical pregnancy with different clinical parameters were successfully treated with methotrexate. Case 1 was a viable cervical pregnancy, case 2 was a cervical pregnancy after curettage that developed into a cervical hematoma, and case 3 was a cervical pregnancy at an early gestational age. The interval between diagnosis and treatment ranged from 45 to 76 days. The maximum quantitative β-human chorionic gonadotropin (β- hCG) levels in cases 1, 2 and 3 were 100,180, 19,093 and 956 mlU/mL, respectively. These patients showed a progressive decline in β-hCG levels, and ultrasound showed a gradual decrease in tire size of the pregnancies. The interval between treatment and β-hCG resolution ranged from 14 to 59 days. Only in case 2 did side effects occur, including stomatitis and transient elevation of scram transaminase. In view of the risks of standard therapy and patients' desire for fertility, methotrexate treatment may be a therapeutic alternative for cervical pregnancy.