Document Detail


Complete abortion of a nonviable cervical pregnancy following methotrexate treatment.
MedLine Citation:
PMID:  15168321     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cervical pregnancy is an uncommon ectopic pregnancy that accounts for approximately <1% of extrauterine gestations. This condition is associated with an extremely high risk of massive hemorrhage and previously often required hysterectomy. Current early ultrasonographic diagnosis and medical management in conjunction with other conservative measures, which include uterine artery embolization and intracervical balloon tamponade, have enabled conservation of the uterus. A young nulliparous patient ultrasonographically diagnosed with a cervical pregnancy and early fetal demise at 11 and 4/7 weeks gestation was managed with high-dose methotrexate and folinic acid rescue treatment. On the second day after treatment was initiated she spontaneously passed an intact gestational sac accompanied by minimal hemorrhage. Treatment was continued, with decreasing serum beta subunit of human chorionic gonadotropin levels and subsiding hemorrhage. Subsequent surgical measures were not required. This case suggests that complete abortion of a cervical pregnancy not necessitating surgical measures can occur.
Authors:
David M Sherer; Mudar Dalloul; Paulus Santoso; Raphael Stimphil; Margarita Sokolovski; Ovadia Abulafia
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  American journal of perinatology     Volume:  21     ISSN:  0735-1631     ISO Abbreviation:  Am J Perinatol     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-28     Completed Date:  2004-09-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  223-6     Citation Subset:  IM    
Affiliation:
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Medical Center, Brooklyn, New York 11203, USA.
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / administration & dosage*
Abortion, Induced* / methods
Adult
Female
Fetal Death*
Gestational Age
Humans
Leucovorin / administration & dosage
Methotrexate / administration & dosage*
Pregnancy
Pregnancy Trimester, First
Pregnancy, Ectopic / therapy*,  ultrasonography*
Time Factors
Treatment Outcome
Ultrasonography, Prenatal
Uterine Hemorrhage / prevention & control
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 58-05-9/Leucovorin; 59-05-2/Methotrexate

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


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