Document Detail


Successful treatment of advanced interstitial pregnancy with methotrexate and hysteroscopy. A case report.
MedLine Citation:
PMID:  9749430     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Data concerning medical treatment of interstitial ectopic pregnancies are scarce. These pregnancies are characterized by late and serious clinical manifestations. We report a case of advanced interstitial pregnancy treated successfully by combining methotrexate (MTX) and hysteroscopy. CASE: A routine ultrasonic evaluation of a 10-week pregnancy revealed a right interstitial gestational sac 58 mm in diameter and containing an embryo with a crownrump length of 29 mm and embryonic heartbeats. Serum beta-human chorionic gonadatropin (hCG) level was 97,950 mIU/mL. The patient was treated with a systemic MTX/leucovorin regimen. At the end of the one-week course, no embryonic cardiac activity was detected, and a decrease in beta-hCG levels commenced. Persistent trophoblastic tissue, manifested by a low (26 mIU/mL) beta-hCG level in plateau, was successfully removed by way of hysteroscopy. CONCLUSION: Early detection of interstitial pregnancy may facilitate conservative medical treatment.
Authors:
A Groutz; Y Wolf; B Caspi; I Wolman; D Gordon; M P David
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  43     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-12-08     Completed Date:  1998-12-08     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:  719-22     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, LisSerlin Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / therapeutic use*
Adult
Antidotes / therapeutic use
Endoscopy*
Fallopian Tubes / pathology,  surgery
Female
Humans
Hysteroscopy*
Leucovorin / therapeutic use
Methotrexate / therapeutic use*
Pregnancy
Pregnancy, Ectopic / therapy*,  ultrasonography
Uterus / pathology,  surgery
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 0/Antidotes; 58-05-9/Leucovorin; 59-05-2/Methotrexate

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