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Comparison of transabdominal and endovaginal sonographic approaches in the diagnosis of a case of cervical pregnancy successfully treated with methotrexate.

Cervical pregnancy occurs in approximately 1 in 16,000 pregnancies. The majority of these cases left untreated will abort spontaneously in the first trimester, apparently because of the unfavorable implantation site. The incidence of cervical pregnancies is rising and may reflect the steady increase in ectopic gestations and cesarean sections. 2 In the past, this diagnosis was made late in the first trimester, usually following heavy vag·inal bleeding (many times leading to emergency hys· terectomy). Currently, the diagnosis is based on ultrasound findings, permitting efforts at conservative treatment. We compare the transabdominal and endovaginal modes of sonography in a case of cervical pregnancy that was subsequently treated with metho· trexate.