Invasive ultrasound in the management of cervical ectopic pregnancy.

Invasive ultrasound management of a 6-week live cervical pregnancy in a 26-year old primipara is described. The patient was given methotrexate three times at seven-day intervals with no effect. Then 15% KCl was administered intra-amniotically via the transvaginal and transcervical route under ultrasound guidance. The procedure was successful, causing fetal death and loss of trophoblastic blood flow on Doppler examination. Over the subsequent four weeks, there was a steady decrease of serum ß-hCG concentration. After four weeks, curettage of the cervical canal and uterine cavity was performed successfully. This method of treatment enabled avoidance of invasive surgical procedures, which might have limited future fertility.