| Combined use of uterine artery embolization and local methotrexate injection in interstitial ectopic pregnancies with poor prognosis. | |
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MedLine Citation:
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PMID: 20110090 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Gemma Tamarit; Elena Lonjedo; Miguel Gonz?lez; S?lvia Tamarit; Santiago Domingo; Antonio Pellicer |
Publication Detail:
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Type: Case Reports; Journal Article Date: 2010-01-29 |
Journal Detail:
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Title: Fertility and sterility Volume: 93 ISSN: 1556-5653 ISO Abbreviation: Fertil. Steril. Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-01 Completed Date: 2010-04-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372772 Medline TA: Fertil Steril Country: United States |
Other Details:
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Languages: eng Pagination: 1348.e1-4 Citation Subset: IM |
Copyright Information:
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Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Obstetrics and Gynecology, Hospital Universitario Dr. Peset, Avenida Gaspar Aguilar 90, 46017 Valencia, Spain. pellicer_ant@gva.es |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Combined Modality Therapy Female Humans Methotrexate / administration & dosage* Pregnancy Pregnancy, Ectopic / diagnosis*, therapy* Prognosis Uterine Artery Embolization / methods* |
| Chemical | |
Reg. No./Substance:
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59-05-2/Methotrexate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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