Document Detail

Combined use of uterine artery embolization and local methotrexate injection in interstitial ectopic pregnancies with poor prognosis.
MedLine Citation:
PMID:  20110090     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To report three cases of interstitial pregnancies treated successfully by combining uterine artery embolization (UAE) and ultrasound-guided local administration of methotrexate (MTX); and to assess the effect of UAE on ovarian reserve by prospectively measuring serum antim?llerian hormone (AMH) levels. DESIGN: Case report. SETTING: Departments of obstetrics and gynecology and radiology of a university hospital. PATIENT(S): Three patients with interstitial pregnancy. Treatment with multiple IM injections of MTX had failed in cases 1 and 3. Case 2 presented high initial serum beta-hCG levels (93,563 mIU/mL), suggesting the presence of a substantial amount of trophoblastic tissue. INTERVENTION(S): All three patients underwent UAE and an ultrasound-guided local injection of MTX under spinal anesthesia. MAIN OUTCOME MEASURE(S): Evolution of serum beta-HCG and AMH levels. Resolution of pregnancies. RESULT(S): All three cases presented an appropriate decrease in serum beta-HCG levels, though this reduction was slower in case 2 because of the initial value. Resolution of pregnancy was achieved without complications in all three cases. Levels of AMH were not affected in any of the patients. CONCLUSION(S): Interstitial pregnancies with a poor prognosis can be treated successfully with a combination of UAE and local MTX. This approach seems to be safe and maintains the ovarian reserve.
Gemma Tamarit; Elena Lonjedo; Miguel Gonz?lez; S?lvia Tamarit; Santiago Domingo; Antonio Pellicer
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-01-29
Journal Detail:
Title:  Fertility and sterility     Volume:  93     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-01     Completed Date:  2010-04-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1348.e1-4     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Department of Obstetrics and Gynecology, Hospital Universitario Dr. Peset, Avenida Gaspar Aguilar 90, 46017 Valencia, Spain.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Combined Modality Therapy
Methotrexate / administration & dosage*
Pregnancy, Ectopic / diagnosis*,  therapy*
Uterine Artery Embolization / methods*
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Ultrastructural deformity of ovarian follicles induced by different cryopreservation protocols.
Next Document:  Competitive interactions between components in surfactant-cosurfactant-additive systems.