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    
Abstract/OtherAbstract:
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.
Authors:
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.
Affiliation:
Department of Obstetrics and Gynecology, Hospital Universitario Dr. Peset, Avenida Gaspar Aguilar 90, 46017 Valencia, Spain. pellicer_ant@gva.es
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MeSH Terms
Descriptor/Qualifier:
Adult
Combined Modality Therapy
Female
Humans
Methotrexate / administration & dosage*
Pregnancy
Pregnancy, Ectopic / diagnosis*,  therapy*
Prognosis
Uterine Artery Embolization / methods*
Chemical
Reg. No./Substance:
59-05-2/Methotrexate

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


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