Document Detail


Laparoscopic cornuotomy in the management of an advanced interstitial ectopic pregnancy: a case report.
MedLine Citation:
PMID:  19718563     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report the successful treatment of an advanced interstitial ectopic pregnancy via laparoscopic cornuotomy following treatment failure with methotrexate (MTX). CASE: A 28-year-old, gravida 3, para 0 woman with a history of successfully treated tubal pregnancy with medical therapy 2 years ago, presented with spotting bleeding and lower abdominal pain. Her initial beta-hCG level was 11706 mIU/ml and the transvaginal ultrasound examination showed an empty uterine cavity with a gestational sac 8 x 10 x 9 mm in diameter having no fetal pole or yolk sac, located just adjacent to the left uterine cornual region. She was introduced 50 mg of systemic MTX with the presumed diagnosis of interstitial pregnancy. Because the serum beta-hCG level raised to 18654 mIU/ml and a fetal pole with cardiac activity emerged on the ultrasound on the fourth day after MTX injection, laparoscopy was planned. The interstitial pregnancy was successfully treated via laparoscopic cornuotomy with the preservation of the uterus. CONCLUSION: In advanced interstitial pregnancies with high hCG levels, systemic MTX therapy is expected to be ineffective. Laparoscopic cornuotomy is a minimally invasive and effective method of treatment with the advantage of preserving future fertility.
Authors:
Murat Api; Olus Api
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology     Volume:  26     ISSN:  1473-0766     ISO Abbreviation:  Gynecol. Endocrinol.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-06-17     Completed Date:  2010-10-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807913     Medline TA:  Gynecol Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  208-12     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Haseki Education and Research Hospital, Istanbul, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
Laparoscopy / methods*
Pregnancy
Pregnancy, Tubal / surgery*

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