| Multiple-dose methotrexate for pregnancy in a cesarean section scar. A case report. | |
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MedLine Citation:
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PMID: 12012889 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Pregnancy developing in a cesarean section scar is a very rare but possibly life-threatening condition because of the risk of rupture and excessive hemorrhage. CASE: A woman with previous cesarean section had transvaginal sonography performed at 7 weeks of gestation that showed a gestational sac implanted in the anterior isthmus wall of the uterus with 3 mm of myometrium between the sac and bladder wall. A diagnosis of pregnancy in the cesarean section scar was made. The patient was asymptomatic, and her hemodynamic condition was stable. Two courses of multiple-dose systemic methotrexate-folinic acid (1 mg/kg methotrexate intramuscularly on days 1, 3, 5 and 7 with 0.1 mg/kg folinic acid intramuscularly on days 2, 4, 6 and 8) were given. The patient tolerated it and remained stable during treatment. The serum hCG dropped to < 5 IU/L on day 56. CONCLUSION: Treatment with methotrexate is a non-surgical option that can improve preservation of the uterus in patients who desire fertility. A multiple-dose regimen causes rapid interruption of the pregnancy. This is very important because the risk of rupture and hemorrhage directly correlates with the duration of the pregnancy. |
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Authors:
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Po Mui Lam; Keith Wing Kit Lo |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: The Journal of reproductive medicine Volume: 47 ISSN: 0024-7758 ISO Abbreviation: J Reprod Med Publication Date: 2002 Apr |
Date Detail:
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Created Date: 2002-05-15 Completed Date: 2002-11-13 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0173343 Medline TA: J Reprod Med Country: United States |
Other Details:
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Languages: eng Pagination: 332-4 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong. lampomui@cuhk.edu.hk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abortifacient Agents, Nonsteroidal
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administration & dosage*,
therapeutic use* Adult Cesarean Section / adverse effects* Cicatrix / etiology*, ultrasonography Dose-Response Relationship, Drug Female Humans Methotrexate / administration & dosage*, therapeutic use* Pregnancy Pregnancy, Ectopic / drug therapy*, ultrasonography |
| Chemical | |
Reg. No./Substance:
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0/Abortifacient Agents, Nonsteroidal; 59-05-2/Methotrexate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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