임상연구 : 자궁경관임신에서 Methotrexate 치료 후 소파술을 시행한 보존적 치료

Objective : To evaluate the safety and efficacy of intramuscular methotrexate injection followed by dilatation and curettage (D & C) for the treatment of ectopic cervical pregnancy. Method : Nine patients with cervical pregnancy were treated alternately with four doses of intramuscular methotrexate (1.0 mg/kg) and four doses of intramuscular folinic acid (0.1 mg/kg). On the seventh day after treatment, patients were measured for level of serum β-hCG (human chorionic gonadotropin) and underwent ultrasounds. According to the result, additional dose of MTX or curettage were done. Serum β-hCG and ultrasound were checked every week until the level of serum β-hCG and the finding of ultrasound had been normalized. Results : Eight patients showed normal level in serum β-hCG and normal finding in ultrasound after the methotrexate/folinic acid therapy followed by D & C. One of nine patients showed increase by double concentrations in serum β-hCG after the MTX/Folinic acid treatment. After intraamnionic injection of MTX, serum β-hCG titer was decreased in this case. One week later, D & C was performed. No patient was experienced severe complications. All patients who had wanted a subsequent pregnancy were conceived. Conclusion : These results suggest that methotrexate/folinic acid therapy followed by D & C is safe and effective as a primary therapy for ectopic cervical pregnancy.