Document Detail


Medical management of interstitial pregnancy with a retained IUD. A case report.
MedLine Citation:
PMID:  10900583     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Systemic methotrexate therapy for interstitial pregnancy has an increased failure rate as compared to other ectopic locations. No case of interstitial pregnancy with a retained intrauterine device (IUD) has been reported on before. CASE: An asymptomatic, 21-year-old woman presented with a positive pregnancy test and a retained IUD. Vaginal ultrasound revealed a left interstitial pregnancy. Diagnostic laparoscopy was followed by a single dose of methotrexate (50 mg/m2). Five days later, a marked increase in the human chorionic gonadotropin level was followed by a second course (four doses) of methotrexate, 1 mg/kg, alternating with 0.1 mg/kg of leucovorin. Concomitant Chlamydia was treated with azithromycin, and the IUD was expelled spontaneously. CONCLUSION: Medical management of interstitial pregnancy may prevent surgery that limits future fertility, but the evidence suggests that more than one dose of methotrexate may be required.
Authors:
J W McBroom
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  45     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-10-25     Completed Date:  2000-12-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  490-2     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA. j_mcbroom@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / therapeutic use*
Abortion, Induced
Adult
Anti-Bacterial Agents / therapeutic use
Azithromycin / therapeutic use
Chlamydia Infections / complications,  drug therapy
Diagnosis, Differential
Drug Therapy, Combination
Female
Humans
Intrauterine Devices*
Leucovorin / therapeutic use
Methotrexate / therapeutic use*
Pregnancy
Pregnancy, Ectopic / complications,  diagnosis,  drug therapy*
Vaginal Diseases / complications,  drug therapy
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 0/Anti-Bacterial Agents; 58-05-9/Leucovorin; 59-05-2/Methotrexate; 83905-01-5/Azithromycin

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


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