Conservative Management of 12 Weeks Cervical Pregnancy following in vitro Fertilization

Abstract

ABSTRACT A 30-year-old, third gravid with two previous abortions, with in vitro fertilization conception with 11 weeks and 6 days of gestation, came with complaints of mild bleeding per vaginum. Ultrasonography revealed a live pregnancy in the cervical canal corresponding to 12 weeks of gestation. Single dose of intramuscular methotrexate 1 mg/kg was given. Three days postmedical management, transvaginal ultrasound-guided intracardiac instillation of potassium chloride 1.5 mL was carried out. Injection methotrexate, 4 mL, was instilled in the amniotic cavity. On day 5 postprocedure, patient had a bout of severe vaginal bleeding for which emergency vaginal exploration was carried out. Products of conception were suctioned out and placenta was removed. Hemostatic cervical vascular sutures were taken on either side to occlude the descending branch of cervical artery. A Foley catheter (18F) was inserted in the cervical canal and distended with 60 mL of normal saline, thereby compressing the placental bed from within the cervical canal. Hemostasis was achieved and maintained. How to cite this article Shah PK, Chaudhari HK, Mantri N, D'souza N. Conservative Management of 12 Weeks Cervical Pregnancy following in vitro Fertilization. J South Asian Feder Obst Gynae 2017;9(2):185-189.