Conservative management of second-trimester cervical ectopic pregnancy with placenta percreta

Objective: To report successful conservative management of advanced cervical ectopic pregnancy with placenta percreta. Design: Case report. Setting: University tertiary care hospital. Patient(s): A 37-year-old woman with second-trimester cervical ectopic pregnancy and placenta percreta. Intervention(s): Ultrasound-guided injection of potassium chloride into the fetal heart followed by multiple systemic methotrexate injections, removal of fetal bones, cervical cerclage suture, and Foley catheter placement for control of hemorrhage. Main Outcome Measure(s): Low maternal morbidity and successful conservative management with preservation of fertility. Result(s): The cervical ectopic pregnancy was treated successfully without significant morbidity; the uterus was preserved, and the woman was delivered of a full-term live fetus in the next pregnancy. Conclusion(s): Advanced cervical ectopic pregnancy with placenta percreta is associated with high morbidity with surgical intervention. Conservative management with attendant low morbidity and uterus preservation is possible in advanced cervical ectopic pregnancy. (Fertil Steril (R) 2007;87:697.e13-6. (C) 2007 by American Society for Reproductive Medicine.)