Subsequent reproduction and obstetric outcome after methotrexate treatment of cervical pregnancy: a review of original literature and international collaborative follow-up

The case reports of 22 patients with cervical pregnancies treated bymethotrexate (MTX) administration and published in English literaturebetween 1983 and 1995 were reviewed, by either original paper review orfollow-up under international collaboration, to determine the subsequentreproductive performance and obstetric outcomes. Out of 22 cases, 18 (78%)MTX chemotherapy attempts succeeded with complete remission and four (22%)failed. Of the 13 women who wished to conceive and could be followed for atleast 3 years, nine succeeded in having live births without congenitalmalformations, one spontaneously aborted and three suffered infertility. Ingeneral, MTX chemotherapy alone or combined with adjuvant methods such assubsequent cervical curettage or cervical tamponade, or intracervicalpotassium chloride injection, appears to be a convenient and effectivemethod for the treatment of the majority of cervical pregnancies before 12weeks gestation, and has not been shown to have detrimental effects onsubsequent reproductive capacities, obstetric outcomes and progeny healthfor those cases with successful preservation of the uteri.