Consecutive cervical pregnancies

Objective: Report of a rare case of consecutive spontaneous cervical pregnancies. Design: Case study. Setting: Teaching hospital. Patient(s): One healthy nulliparous woman in the early years of her fourth decade. Intervention(s): The first of two cervical pregnancies was treated with two doses of methotrexate and subsequent uterine artery embolization. The second was treated with methotrexate, intracervical Foley catheter placement, hysteroscopic ablation of the bleeding cervical bed, and replacement of the Foley catheter with gradual deflation of balloon. Main Outcome Measure(s): Recognition and successful treatment of cervical ectopic pregnancy. Result(s): Each of the two cervical pregnancies was successfully treated. The patient subsequently carried a spontaneous intrauterine pregnancy to term. Conclusion(s): A comprehensive MEDLINE search revealed that this appears to be the first reported case of recurrent spontaneous cervical pregnancies, and only the second known case of recurrent cervical pregnancy. Cervical pregnancies have generally been treated with hysterectomy because of the potential for massive hemorrhage. However, current treatment options permit effective conservative management in women who desire continued fertility. This case illustrates various treatment options, under different circumstances, in the same individual. (C) 2004 by American Society for Reproductive Medicine.