Document Detail


Laparoscopic salpingocentesis using methotrexate in combination with oral mifepristone for successful treatment of interstitial pregnancy: a case report.
MedLine Citation:
PMID:  19819446     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report two cases of women who presented with amenorrhea, lower abdominal pain, and vaginal bleeding and who were diagnosed with advanced interstitial pregnancy after initial negative laparoscopies. DESIGN: Case report. SETTING: Early pregnancy unit of district general hospital. PATIENT(S): A 39-year-old woman with a history of right salpingectomy for ectopic pregnancy and a 28-year-old woman with a history of miscarriage. INTERVENTION(S): Laparoscopic salpingocentesis with methotrexate (50 mg/m(2)) after aspiration of an equivalent amount of amniotic fluid. The remainder, based on the calculated dose, was given intramuscularly. Oral mifepristone (200 mg) was given postoperatively. MAIN OUTCOME MEASURE(S): Complete resolution of interstitial pregnancy in both instances with two subsequent, successful intrauterine pregnancies delivered at term in the second patient. There were no intraoperative or postoperative complications. RESULT(S): Expected decline in beta human chorionic gonadotropin (beta-hCG) levels without the need for any further intervention(s). CONCLUSION(S): Interstitial pregnancy may be successfully and safely managed by the use of laparoscopic salpingocentesis with methotrexate and mifepristone despite high initial beta-hCG levels.
Authors:
Latika Narang; Gregory Kalu
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-10-12
Journal Detail:
Title:  Fertility and sterility     Volume:  92     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-07     Completed Date:  2010-01-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2038.e5-7     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, Princess Royal Hospital, Haywards Heath, West Sussex, United Kingdom. latikaong@yahoo.co.uk
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / administration & dosage
Abortifacient Agents, Steroidal / administration & dosage
Administration, Oral
Adult
Amniotic Fluid
Combined Modality Therapy
Fallopian Tubes / surgery
Female
Humans
Laparoscopy / methods*
Methotrexate / administration & dosage*
Mifepristone / administration & dosage*
Pregnancy
Pregnancy, Tubal / drug therapy*,  surgery*
Suction / methods
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 0/Abortifacient Agents, Steroidal; 59-05-2/Methotrexate; 84371-65-3/Mifepristone

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


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