Cervical Pregnancy

QUESTION

Dear Midwife,
I had a very rare cervical pregnancy at 6 weeks. It was my second pregnancy, first was perfectly fine. No history of miscarriages. I was admitted into the hospital and had potassium chloride injected into the gestational sac to stop the heartbeat of the fetus. I have been having methotrexate injections and 4 days after receiving the KCL I had to have methotrexate injected in the remaining tissue still dividing. Today my hCg levels decreased from 21000 to 17000, I will be monitored to make sure they get back to zero. I had 5 doses (63 mg) of methotrexate.

My question is how long does methotrexate stay in my system? What are the chances of a healthy pregnancy in the future? Have you had any experience with this rare type of ectopic pregnancies?

Shocked...

ANSWER

The half-life of the drug is 15 hours with a high dose, so half the drug is out of your system by then, and the rest follows soon after. This sounds like one of those truly rare events that is unlikely to recur, and no I have never had (nor heard of) such a thing. All I can say from what you describe is that this may be one of the better places to have an ectopic, only in that the cervix is such a forgiving organ which heals itself from various insults by itself without us having to do anything at all.

I am so sorry you are having to go through all this, but hopefully the next pregnancy will go just fine.

Good luck!
-- Cynthia, CNM. PhD.

Comments

Are you still here?

I am currently going through the same thing... about 6 weeks pg with a diagnosis of cervical pregnancy... However I never did have fetal cardiac activity. I got the 4 rounds of Methotrexate and my levels have been decreasing... however it has been over a month now and I still have a hcg of close to 1000 plus I am having terrible cramping. Just curious if you are around and how long the hole process took you and if you had any pain?

Thanks

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.