Document Detail


Serial transvaginal sonographic findings of cervical ectopic pregnancy treated with high-dose methotrexate.
MedLine Citation:
PMID:  19106357     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We analyzed transvaginal sonographic findings from patients with cervical ectopic pregnancies treated with high-dose methotrexate (MTX). METHODS: This was a retrospective analysis of cervical pregnancies diagnosed in our institution from 1996 through 2006. We divided the cases into an MTX treatment group and a surgical treatment group. We included cases treated with high-dose MTX alone. We analyzed 9 cervical ectopic pregnancies treated with MTX, which was injected intravascularly at 100 mg/m(2) plus 200 mg/m(2) in 500 mL of a normal saline solution with folinic acid rescue. The gestational sac sizes and serum human chorionic gonadotropin (hCG) levels were periodically monitored to determine the resolution status. RESULTS: Fifty cervical pregnancies were diagnosed during the study period. Thirty cases were treated with MTX, and 20 were treated with surgical procedures. Among the 30 cases in the MTX treatment group, 9 had high-dose MTX injection without surgical procedures. Cervical mass regression appeared at a median of 40 (range, 10-88) days after treatment, whereas the serum hCG level decreased at a median of 14 (range, 9-17) days after treatment. The median time to complete regression of the cervical mass was 86 (range, 48-141) days, and the median time to complete regression of the serum hCG level was 68 (range, 19-143) days. Cervical pregnancy was noted as a gestational sac at first but coexisted with a mixed echoic lesion 19 days after treatment. At 33 days after treatment, the cervical pregnancy was completely replaced by the mixed echoic lesion. CONCLUSIONS: Resolution of the cervical mass on sonography lagged far behind resolution of the serum hCG level. The cervical mass evolved from a gestational sac into a mixed echoic lesion on serial transvaginal sonography.
Authors:
Mi Jin Song; Min Hoan Moon; Jeong-Ah Kim; Tae Jin Kim
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  28     ISSN:  1550-9613     ISO Abbreviation:  J Ultrasound Med     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-24     Completed Date:  2009-02-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  55-61     Citation Subset:  IM    
Affiliation:
Department of Radiology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea. radsmj@msn.com
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / therapeutic use*
Adult
Cervix Uteri / ultrasonography*
Female
Humans
Pregnancy*
Pregnancy, Ectopic / therapy*,  ultrasonography*
Prognosis
Treatment Outcome
Ultrasonography, Prenatal / methods*
Vagina / ultrasonography*
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal

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


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