Document Detail


Successful management of live ectopic pregnancy with high beta-hCG titres by ultrasound-guided potassium chloride injection and systemic methotrexate.
MedLine Citation:
PMID:  19229547     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Methotrexate (Mtx) is accepted modality for conservative treatment of ectopic pregnancy. However, there is no consensus regarding its use in live ectopic pregnancy and high serum beta-human chorionic gonadotrophin (beta-hCG) titres. CASE REPORT: We report a successful management of live ectopic pregnancy in a 27-year-old nulliparous woman, with very high beta-hCG titres (89,200 mIU/mL), using ultrasound-guided intra-sac potassium chloride (KCl) injection and systemic Mtx. Successful resolution of the ectopic pregnancy, with negative serum beta-hCG (<1 mIU/mL) was achieved after three doses of Mtx, and a prolonged follow-up of 71 days. No treatment related complications were encountered. CONCLUSION: Concurrent use of intra-sac hypertonic KCl, to produce cardiac asystole, with systemic Mtx could potentially improve outcome in live ectopic gestations with very high serum beta-hCG titres. However, individualised treatment, with a stringent follow-up regime is mandatory in such cases.
Authors:
Vatsla Dadhwal; Deepika Deka; Bhaswati Ghosh; Suneeta Mittal
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-02-20
Journal Detail:
Title:  Archives of gynecology and obstetrics     Volume:  280     ISSN:  1432-0711     ISO Abbreviation:  Arch. Gynecol. Obstet.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-09-25     Completed Date:  2010-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710213     Medline TA:  Arch Gynecol Obstet     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  799-801     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. vatslad@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Chorionic Gonadotropin, beta Subunit, Human / blood*
Female
Humans
Methotrexate / administration & dosage*
Potassium Chloride / administration & dosage*
Pregnancy
Pregnancy, Ectopic / blood*,  drug therapy*
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin, beta Subunit, Human; 59-05-2/Methotrexate; 7447-40-7/Potassium Chloride

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