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In the nick of time

Despite 2 treatments a cervical ectopic pregnancy continued to advance
Published:January 30, 2012DOI:https://doi.org/10.1016/j.ajog.2012.01.027
      A 36-year-old nulligravid woman, who had conceived by intrauterine insemination, was referred for a known cervical pregnancy. The ectopic pregnancy was initially diagnosed at 6 weeks 6 days of gestation. Asingle-dose intramuscular injection of systemic methotrexate, 50 mg/m2, was administered at 7 weeks' and again at 9 weeks' gestation at her local hospital, but these failed to successfully treat the ectopic gestation. The patient subsequently presented to our institution at 11 weeks 1 day for further management. Her human chorionic gonadotropin (hCG) level at that time was 26,861 IU/L. She denied any vaginal bleeding or pain.
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