Enhanced Magnetic Resonance Imaging in Monitoring of Conservative Treatment of Cervical Pregnancy

Abstract

We report on case of cervical pregnancy successfully treated by two 5-day courses of etoposide, embryocide with the injection of KCl, the injection of methotrexate into the placenta, and cervical curettage. We evaluated the effects of these treatments by measuring urinary human chorionic gonadotropin (hCG) titers and serial hCG beta-carboxy-terminal peptide (CTP) levels. Moreover, we used ultrasonography and magnetic resonance imaging (MRI) enhanced by gadolinium-diethylenetriamine-pentaacetic acid (Gd-DTPA) to diagnose and to evaluate the blood supply to the trophoblast. The beneficial outcomes suggest that Gd-DTPA-enhanced MRI is useful in detecting the blood supply to the trophoblast, in order to avoid the massive bleeding that results from conservation treatments. This is the first report of the usefulness of Gd-DTPA-enhanced MRI for the successful conservative treatment of cervical pregnancy.